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Patient Forms


If you are a new patient, please print and complete the following forms and bring them with you to your first visit:

Adult Consent Form
Pediatric Consent Form


If You Wish To Have A Copy Of Your Medical Records Released To Another Party, Please Complete The Authorization Form Below And Bring It To Our Office:

Authorization for Disclosure of Protected Health Information


For sports physicals, please print and complete the following form and bring it with you to your child's visit:

OHSAA Sport Pre-Participation Physical Evaluation Form