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Patient Forms

Forms and Documents

Please print and fill out all applicable forms and present them to the front desk when you arrive for your first office visit.

Patient Forms

New Adult Patient Registration

New Child Patient Registration

Member Documents

2022 Advanced Health Care Directive (English)

2022 Advanced Health Care Directive (Spanish)

Online Grievance Form

Notice of Privacy Practice

2022 Language Assistance

Educational Resources

Diabetes

Pre-Diabetes Self Assessment
Type 2 Diabetes Risk Assessment
New Child Patient Registration

Heart Health

Heart Health Risk Assessment
Hands-Only CPR
Stroke Symptoms

Smoking

Become Smoke-Free
Resources to Quit Vaping
Make a Plan to Quit Smoking

Weight Management

BMI Measurement
Weight Management Help

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