Online Patient Forms

New patient forms

Save time by completing your patient forms online before your appointment.

Step 1

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New patient registration View

Step 2

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General health assessment View

Step 3, if needed

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Other patient forms View

Telehealth forms

Telehealth is available to all new and existing patients

Telehealth consent form

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Behavioral health therapy services

Below two forms require your signature. Use your mouse or complete the forms using a touch screen device (smart phone, tablet) for the signature.

Behavioral health informed consent form

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Behavioral health notice of privacy practices

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Nutrition services

Thriving with diabetes assessment form

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Health risk assessment forms

Health risk assessment form

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Electronic signature required for forms below

Submitted online, no printing required. The forms below require your electronic signature. Complete and sign using a touch screen device (smart phone, tablet, touch screen computer, or a laptop/desktop with a mouse) for the signature.

Authorization for release of medical records

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Authorization for disclosure of medical information

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Credit card authorization cancellation

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Payment plan application

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Other forms

All other forms

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Don't delay the care you need.

Open 7-days a week with same-day appointments.