Forms
After scheduling a visit with your Partnership Health Center, you may be asked to fill out a form(s) to bring with you to your appointment. Our staff will inform you of which form(s) you will need.
Below you can find these forms. If asked, please download, print out, fill-in, and bring the requested forms to your appointment. If you have any questions about which form(s) is needed, please call your Partnership Health Center.
**Please note that all new must patients must complete the New Patient History, Patient Information, and Consent for Treatment forms.
General Forms
New Patient History
Patient Information
Consent for Treatment
Medical Records Release
Tele-therapy Policy and Consent
Vaccination Forms
COVID-19 Testing Consent Form
COVID-19 Lab Requisition Form
Vaccine Information Statement
Flu Screening Checklist