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 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

Notice of Privacy Practices

Vaccination Forms

COVID Vaccine

Consent - J&J

COVID-19 Lab Requisition Form

Long Branch Weekly Testing Form

COVID Vaccination Checklist

Vaccine Information Statement

Flu Screening Checklist

COVID-19 Testing Consent Form

NJIIS Consent Form

COVID Vaccine Consent - Moderna 

COVID Vaccine Consent - Pfizer

COVID Booster Eligibility