Patient Forms

If you are a new patient, please print and complete the following forms and bring them with you to your first visit:

Authorization for Disclosure of Protected Health Information Form
Health History Form
HIPAA Release Form (if patient is adult)
HIPAA Release Form for Minors (if patient is minor)

For sports physicals, please print and complete the following form and bring it with you to your child's visit:

OHSAA Sport Pre-Participation Physical Evaluation Form