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 2022-04-01

Medical Center Patient Registration Form Rev 2022-04-01 – Spanish

AUTHORIZATION FOR USE AND DISCLOSURE OF PROTECTED HEALTH INFORMATION

Communication Release Form

Communication Release Form_Spanish

New Adult Patient Questionnaire Revised 7_13_2022

New Adult Patient Questionnaire Revised 7_13_2022_ES

Consent for Treatment of Minor Child

Consent for Treatment of Minor Child_Spanish

Please read Hot Springs Health Program’s VaccinePolicy