Services

Patient Forms

All New Patients:
If you are a new patient coming into the clinic for the first time, print, complete and bring the New Patient Packet with you to your appointment.
New Patient Packet (PDF)

Advanced Directive:
An advance directive is a written document in which people clearly specify how medical decisions affecting them are to be made if they are unable to make them, or to authorize a specific person to make such decisions for them. If you are interested in receiving a copy of an advanced directive, you may download it here or request one from the SHS front desk staff.
Advanced Directive (PDF)

Specialty Forms:
Print and complete these forms only if they are relevant to your appointment.
Medical Records Request / Release (PDF)
Authorization for Disclosure Health Information (PDF)
Parental Consent for Treatment of a Minor: General Care
Alternate Parties Authorized to Consent for Medical Care for Minor
Parental Consent for Administration of Vaccines for a Minor
Parental Consent for Administration of Influenza (Flu) Vaccine for a Minor
Parental Consent for Imaging of a Minor
Parental Consent for Serum Testing of a Minor