Policies and Forms

New Patient Registration

Patient Responsibilities

Patient Medical Release

Guardian Authorization

Photo Consent Form

COVID-19 VACCINE FORM

FILL OUT COVID VACCINE, DOWNLOAD AND BRING TO YOUR APPT

COVID-19 FACT SHEET FOR RECIPIENTS AND CAREGIVERS

Form Fees: $5.00 fee for each form completed, payable in advance.

Forms will be ready a minimum of 2-3 business days after submission.

$10.00 fee for same-day form.