Patient Forms

Below is a list of the most common Forms used by our patients.  To access and complete your form, just click on the Form name.

Notice of Privacy Practices

18+ years HIPAA Consent

Behavioral Assessment Forms

Consent to Treat Minor

Flu Vaccination Forms

Medical Records Release Forms

Medications for School Form

New Patient Forms

Note:  Please call our office before completing our New Patient Forms if you are looking to become a new patient to our Practice.

PHQ-9 Well Visits 13yrs+

Note: Please email completed PHQ-9 forms to [email protected] prior to your scheduled Well Visit if you did not complete during your Phreesia pre-registration.

School, Camp, Sports, Daycare, and Other Forms

Please review our Form Policy before completing our brief questionnaire and have it with your form when you bring/send it in to us.

Our Location

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Hours of Operation

Medical Office - Saturday is not a walk-in clinic. Please call for same-day-appt time after 8:30am

Medical Office

Monday:

8:30 am-4:30 pm

Tuesday:

8:30 am-4:30 pm

Wednesday:

8:30 am-4:30 pm

Thursday:

8:30 am-4:30 pm

Friday:

8:30 am-4:30 pm

Saturday:

8:30am-11:30am Due to ongoing caution during COVID-19 our Saturday hours will be via telemedicine until further notice.

Sunday:

Closed