BIG LAKE CLINIC FORMS

General Registration Forms

• Big Lake Clinic Consent Form

• Financial Policy

• HIPPA and Privacy Notice

Clinical History and Consent Forms

• Health History-Adult (21 years+)

• Health History-Adolescent (12-20 years)

• Health History-Child (0-11 years)

• Parental Consent to Treat a Minor

• Parental Consent for Allergy Shots for a Minor

• Sports Physical Forms

Miscellaneous Forms

• Records Release/transfer

• Health Care Directives

• Customer Concern Form

• MyChart Proxy Form

• Verbal Release of Information

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