Patient Paperwork

When you make an appointment through our website you will be sent an invitation to set up a patient portal through our electronic health records system Charm. Once you have set up your account you will see new patient paperwork in the questionnaires tab (you will also receive an email alerting you of questionnaires to fill out). Please fill out the requested questionnaires prior to your appointment. You may also get a text message from our billing department to get a picture/ copy of your insurance card. If we do not reach out for this prior to your visit we will ask for your card at your visit to make a copy for your chart. 

List of Patient Forms: 

New Patient Intake Form (Adult):

New Patient Intake Form (Pediatric):

Adult Preventative Visit Paperwork:

Link to Upload your Insurance Card to Us:

Informed Consent and Release:

Copy of Clinic Policy:

Copy of HIPAA Notice:

Form to Update your Preferred Pharmacy:

Records Release to our clinic:

Records Release from our clinic:

Schedule Your Appointment Today

Our Locations:

“What the world needs now is more people like you: caring and compassionate caregivers.”

– JP

Receive health tips, insightful articles, and our latest updates by joining the list.

  • This field is for validation purposes and should be left unchanged.