Forms

After scheduling a visit with Partnership Health Centers,

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 patients must complete the New Patient History, Patient Information, and Consent for Treatment forms.

General Forms

New Patient History

Consent for Treatment

Tele-therapy Policy and Consent

Patient Information

Medical Records Release

Mental/Emotional Health

Privacy Policy

Privacy Policy

Vaccination Forms

Vaccine Information Statement

Flu Consent Form

COVID Vaccine Consent - Moderna