We know that your first visit can be stressful, but we’re here to help you make that process go as smoothly as possible!
What To Expect
Plan to spend the first 15 minutes completing registration forms if you did not fill them out prior to your visit.
What Should You Bring?
- A photo ID (Any picture identification card, such as a driver’s license or work ID)
- Any medications and dietary supplements you’re taking now
- Your medical history
- Any information about past or present health problems, surgeries, or family health history and immunization records.
What You Should Bring if You Have Insurance
- Health Insurance Card
- Co-payment
If You Don’t Have Insurance
Complete the Discount Application and bring proof of income. This is used to help enroll you in our discount program or payment plan if necessary.
Questions?
Please carefully review, print, sign, and bring each form with you to one of our clinics, this will save you time.
Required Forms: Blue Forms
Intake Form (Download |
Notice of Privacy Practices (Download)
Medical Release (Download)
Patient Rights (Download)
Sliding Scale Details (Download)
Sliding Fee Scale Application (Download | Online)
Patient Portal (Download | Login)
Required Forms: Blue Forms
Intake Form (Download
Medical Health History (Download)
Discount Program Details (Download)
Sliding Fee Scale Application (Download | Online)
Behavioral Health Forms
Required Forms: Blue Forms + Adult -OR- Child -OR- Adolescent History
Patient Intake (Download
Patient Expectations and Consent (Download
Adult History (Ages 18 and up) (Download
Child History (Ages 17 and under – parent completes) (Download
Adolescents History (Ages 13-17 – adolescent completes) (Download
Medical Release PHI (only if requested) (Download
Discount Program Details (Download)
Sliding Fee Scale Application (Download | Online)
Other Forms
HMIS -Privacy and Security Notice (Download)
Good Faith Estimate (Download)