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Patient forms

View and download any of the forms you see here.

Forms and resources

Permission to treat

Provide permission to allow medical treatment of a minor at ProHealth.

Patient representative release

Authorize someone to access your health history and speak with ProHealth staff on your behalf.

Medical release

Authorize the secure sharing of your medical records.

Preventive visit information

Learn what’s covered in your preventive care appointment.

Financial liability

Review the notice of financial responsibilities for care received at ProHealth.

Self-pay waiver

Confirm your choice to pay directly for services without insurance.

Bone density questionnaire

Share your bone health history before your screening.

Advisory Council application

Apply to help improve patient care at ProHealth.