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Patient Registration Forms

Download the clinic-required forms before your next visit.

Workers' Compensation

If you're being treated at the clinic for the first time for a work-related injury, please bring this form filled out by the employer. 

Physical Exam

Bring your physical exam form filled out to save you some time when you check-in.

DOT/DMV Physical

Bring your clinic-specific DMV/DOT physical forms with you to your visit. Recommend having a list of medications and surgical history for our medical provider to review, if deemed necessary in order to complete the examination.  

Medical Release of Information

Fill out this form to request your information to be released. Return the form in-person, mail it to the clinic, submit through the patient portal or send it securely through our website here

Minor Consent -Informed Consent Authorization (17 years old and younger)

Use the following form to authorize an individual who is not a parent or legal guardian to accompany a minor patient to the clinic for medical treatment.

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