For All New Patients

Patient Info (English)

Patient Info (Spanish)

Healthy History HBC (English)

Healthy History HBC (Spanish)

COVID19 Screening Form (English)

COVID19 Screening Form (Spanish)

Patient Signatures and Policies (English)

Patient Signatures and Policies (Spanish)

For Children – Parent or Guardian to Fill Out

Authorization to Treat Minor HBC

For PI Patients

PI Intake HBC (English)

PI Intake HBC (Spanish)

For Work Comp Patients

Work Comp (English)

Work Comp (Spanish)

For Current Patients, with changes

Change of Condition Report HBC (English)

Change of Condition Report HBC (Spanish)

For Patients who want records for themselves 

Patient Record Authorization Self HBC

Release of Healthcare Information Facility HBC