Forms

Please click on which form(s) you need to download. After downloading the form(s), please fill out the information, sign it and click on the submit form button. If you have a fax and would like to fax the information to your pcp, please click on your pcp name. David W. Douglas, Alain Chaoui, Francis M. Harte, Prathima Reddy.

•  Medical Consent Form

• Behavioral Health Consent Form

• Telemedicine Health Consent

• Psychotherapy Consent

• Authorization to Release Records Form

• Workers Comp Form

• Sharecare Records Release Form

• HIPPA Policy