Clinic Forms

Intake Form

A completed intake packet and a copy of your insurance cards are required prior to scheduling your appointment.

Please contact our office to have the intake documents sent directly to you via our patient portal. Alternatively, you may print the intake forms below, complete them, and return them to The Clinic to book your appointment.

If you have any questions, please don’t hesitate to contact the front desk.

Full Packet

Release of Information

This form authorizes The Clinic to share your protected health information with a person or organization you specify, in accordance with federal and state privacy laws.

To receive the form through the patient portal, please contact our office.

Release Form