New Patient Forms

Establishing patients, please see ALL forms below, not just the Patient Registration form. We need them all completed when you come in to establish with us.

Please print, fill out, and bring in all forms, thank you.

Medical Center Patient Registration Form Rev 2023-09-23

Medical Center Patient Registration Form Rev 2023-09-23 – Spanish

AUTHORIZATION FOR USE AND DISCLOSURE OF PROTECTED HEALTH INFORMATION

Communication Release Form

Communication Release Form_Spanish

New Adult Patient Questionnaire Revised For Epic 5_11_23

New Adult Patient Questionnaire Revised 5_11_23 en Espanol

Consent for Treatment of Minor Child

Consent for Treatment of Minor Child_Spanish

Please read Hot Springs Health Program’s VaccinePolicy

Medical Center Consent Form Rev 2023-08-21

Medical Center Consent Form SPANISH – Rev 2023-08-21