Outpatient Services

Outpatient Forms

outpatient forms

NEW Patient Forms

Please complete your new patient forms before your appointment. They are available to be completed online through MyChart or by printing out the appropriate form below. 

To start your pre-appointment forms using MyChart:

If you are a Telehealth client, you must complete the online forms on MyChart. Please complete the online form at least 24 hours before your first appointment.

  1. Go to MyChart sign up page.
  2. Get your MyChart Activation Code from the email you were sent. If you can’t find your email or it’s been more than 2 weeks since you received the email, please call us to get a new activation code.
  3. Once you’ve activated your MyChart account, complete the forms waiting for you.

Printable forms

Please bring a completed New Client Form to your first visit if you do not complete the online form. The form must be completed in black or blue ink.

Release of Information Forms

In order to share your Protected Health Information (PHI), you will need to complete and sign a Release of Information form. Please complete the form in your MyChart account, print out and complete and form and bring it to your clinic the next time you visit, or ask for a paper form at the office.  

If you need assistance, please call 866.852.4001.