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Forms

We Change Lives

Health Form (Intake)
This is a form that you will fill out prior to your first appointment at Health Services. You may print it out, complete it, and bring it with you to your first appointment. 

HIPAA Form
This form review your rights to your medical records and standards developed by Department of Health and Human Services. 

Parental Consent
When a student/patient is a minor (under age 18), Parental consent is REQUIRED in order for medical services to be rendered. 

Bill of Rights
This form reviews your rights as a patient seeking services at our facility.