Health Services Forms

Need a Form for Health Services?

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Required For ALL Appointments:

• Consent to Treat Form
• Consent for Telemedicine
• Consent Forms (Consent to Treat, Telemedicine, and No Show Policy)
• No Show Fee
• Patient Registration Form

Service Related Forms:

• Caregiver's Authorization Affidavit
• COVID Test Exception Form
• General Health History Questionnaire
• Medical Records Release Form
• Parental Consent For Minors
• TB Risk Assessment and Testing Form: Part I
• TB Screening Questionnaire Form: Part II
• Well Woman Exam Questionnaire