New Patient Registration Forms

New patients should complete the following forms in their entirety:

Patient Registration

Patient Health Questionnaire

Medical Records Release

New Patient Registration Forms (Children under 18)

Patients under the age of 18 should have the following forms completed in their entirety by a parent or guardian:

Patient Registration

Pediatric Patient Health Questionnaire

Medical Records Release

Family Assistance Plan (for uninsured patients)

Family Assistance Plan - information

Family Assistance Plan - application

Family Health Center Notice of Privacy Practices