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Forms
Patient Forms
Request a form online by clicking Message Us on the right
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
Screening
Securely send medical records to us!
Screening
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
Upload
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