Forms

Forms

New Patient Forms

All new patients need to complete our new patient paperwork before they can be seen at the clinic.

  1. New Patient Paperwork. Please print, complete in their entirety and bring to your appointment.
  2. Please read Notice of Privacy Practices
  3. Release of Records

If you have been seen by another provider and wish to follow up care at the health clinic please complete a release of records form prior to your appointment so we can give you the best care possible.

Please bring you medications with you to your appointment, or take photos of them with your phone. It is important that we have the name, dose and frequency of all medications that you take.