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Electronic Patient forms
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All new patient forms can be completed during the check-in process
New to ClearPath Family Healthcare?
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HIPAA Authorization Form
Use this form to authorize how we may contact you or who should have access to your records
Medical Record Request Form
Use this form to authorize the release of your medical records or request records
Portal Request
Use this form to request portal access or to reset your portal password
Simple & Fast!
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Consent to treat a minor
Use this form to allow medical treatment of a minor when a parent or guardian is unavailable
Behavioral Health Informed Consent
Use this form to allow medical treatment of a minor when a parent or guardian is unavailable
Physical Care Informed Consent
Use this form to allow medical treatment of a minor when a parent or guardian is unavailable
Everything in one place!
Depression Screening (PHQ 9)
Use this form to identify signs of depression
Anxiety Screening (GAD 7)
Use this form to identify signs of anxiety
Social Determinants of Health (SDOH)
Use this form to help identify and remove barriers to your medical care
Save time and complete everything online!
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