Patient Forms

There are several forms that may be required for your appointment at OFHC. You can greatly streamline your visit by filling them out ahead of time. Thank you.

You will need a .pdf viewer to view and print these forms.

(All materials are available in Spanish at the office.)

New Patients

Please print and complete the following forms before your appointment with us.

OFHC Notice of Privacy Practices

OFHC Acknowledgement of Receipt Notice of Privacy Practices

New Patient Intake Form and Health Questionnaire

Communication Preferences

Medical Records Requests

To have another provider transfer your medical records to our clinic, please complete the following form and send it them via fax or mail. You may also drop off the form at our office. Authorization to Release Health Care Information to OFHC

To have OFHC transfer your health care records to another health care provider, please complete the following form and deliver it our office by fax, mail, or hand delivery. Authorization for OFHC to Release Health Care Information

Medication Management Forms

Your provider may ask you to complete certain forms before your medication management appointment.

Generalized Anxiety Disorder-7 (GAD-7)

Patient Health Questionnaire-9 (PHQ-9)

Patient Pain Questionnaire

Comments are closed.