2022-2023 Preparticipation Physical Evaluation Form (Ohio High School Athletic Association)

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Adult Demographic/Registration Form

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成人健康史表格

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Agreement of Financial Responsibility Form

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Authorization to Release Information

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Checking In for Your Appointment from 首页。

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Comprehensive Primary Care Plus (CPC+) Information

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Consent for Prescribing Opioids to Minors Form

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同意拍照表格

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COVID-19信息表-阿拉伯语

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COVID-19 Info Sheet - English

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COVID-19 Info Sheet - French

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COVID-19信息表-尼泊尔

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COVID-19 Info Sheet - Somali

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COVID-19 Info Sheet - Spanish

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Designation of Another Person to Consent for Treatment Form

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Health Information Exchange Withdraw – Adult

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Health Information Exchange Withdraw – 儿科

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HIPAA Notice of Privacy Practices

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新成人病人表格

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新儿科病人表格

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Parent/Guardian Consent for COVID-19 Vaccine

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Pediatric Demographic/Registration Form

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儿科给药表

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Pediatric Health History Form

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Receipt of Notice of Privacy Practices

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Request for an Accounting of Disclosures of Protected Health Information (PHI)

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Request to Amend Protected Health Information (PHI) Form

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Request to Restrict Protected Health Information (PHI) Form

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STARK Notice - 患者信息

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视图ing Test Results on the Patient Portal and Healow App

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