Client Forms

Before arriving for your first appointment

Before arriving for your first appointment, please print and complete the appropriate registration packet. To help expedite your appointment, please bring the completed forms with you. If you are unable to complete the forms, please arrive 30 minutes early for your initial appointment so you can complete the forms at our office.

• Packets:

  (Please use black ink when filling out forms)

  Child Packet: Ages 0-12

  Child Registration Packet

  Adolescent Packet: Ages 13-17

  Adolescent Registration Packet 

  Adult Packet: Ages 18 and up

  Adult Registration Packet

• Miscellaneous Forms:

  Release of Information

  Medica Members Only:  Wellness Assessment – Adult

  Medica Members Only:  Wellness Assessment – Youth

  Policies:

  Important information about your rights and responsibilities in relation to your health care.

  Client Information, Financial Policy, & Client Rights

  Privacy Practices Policy