Online Health Forms

Registration Forms

» Assignment of Benefits Form
» Consent for Injection Form
» New Patient Registration Form
» Phone Consent Form
» Routine Physical Consent Form
» Consents and Notices
» STD Consent Form
» Medical Release Form
» Non-Parent Authorization form (Please fill this out and bring into the clinic if you would like someone other than a parent to be able to bring your child in for a visit. Please note that without this form filled out and signed by a parent, we will not see the child without you, and the appointment will be rescheduled. (verbal authorization over the phone not accepted))

Privacy Notices

This privacy notice describes how health information about you may be used and disclosed and how can access this information. Please review it carefully.

» Privacy Practices