Secure Digital Forms
The forms below are only provided to you by your doctor if needed. We value your health information, and we want to make sure your security is guaranteed.
The New Patient Enrollment Form which personal information, contact information, emergency contact and medical history information are provided.
Patient Telehealth Consent Form
A telehealth consent form is used to gather informed consent from patients agreeing to telehealth services for diagnosis or treatment.
Patient Payment Authorization Form
With a payment authorization form, you can collect authorization for payment from your customers before making a payment.
Access Form
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This form is used by patients to register clinical history by providing their personal and contact information, weight, drug allergies, illnesses, operations, healthy habits, etc.
Patient Consent to Release of Information Form
This form allows a patient to give authorization to 3rd party and access their health records. A medical release form can be revoked at any time by the patient.
Patient Insurance Form
Patient Insurance Form is used to confirm that a patient has the necessary insurance coverage for any services they receive.
GAD-7 Outcome Measures
The Generalized Anxiety Disorder Assessment (GAD-7) is a seven-item instrument that is used to measure or assess the severity of generalized anxiety disorder.
PHQ-9 Form
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The Patient Health Questionnaire (PHQ-9) is a multipurpose instrument for screening, diagnosing, monitoring and measuring the severity of depression.
Medical History Form
A HIPAA authorization form gives covered entities permission to use protected health information for purposes other than treatment, payment, or health care operations.
Medical Consent for Minor Form
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A medical consent form for minors is used to get consent from parents or guardians before a child receives medical treatment.
Disability Accommodation Request Form
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Disability Accommodation Request Form is a document created and used to gather data concerning request that patients may have for reasonable accommodations.
HIPAA Authorization Form
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This Patient Medical History Form template is used by patients to register clinical history through providing their personal and contact information.