Patient Paperwork

The patient intake, consent to treat, and patient notice form below are to be completed by new patients.

Further down the page you will find the two release of information forms to be completed if you would like to send health records in or out of Integracare.

All forms can be completed/submitted online, or they can be printed and brought into the office.

Patient Intake Form

This paperwork asks about your symptoms that you will be seen for during your appointment.

Consent to Treat Form

This consent to treat must be signed prior to receiving care at the clinics.

Privacy Policy

This notice applies to the medical records maintained by this office and it specifically details how your medical information may be used and disclosed to third parties. This notice also details your individual rights regarding your medical records.