Click on the following links to download the associated forms for your records. Please be sure to review the COVID-19 Clinic Protocol prior to your appointment. The COVID-19 Informed Consent to Treat and COVID-19 Screening forms must be on file for each patient in order to receive treatment. Failure to complete these forms prior to your appointment may result in cancellation of your appointment and rescheduling to a later date.
CURRENT PATIENTS: Please log on to your Patient Portal to complete these forms under the Questionnaire folder. To request a new link to create a Patient Portal account, email helpu2heal@yahoo.com
If you are having difficulty accessing your Patient Portal:
1) Download and complete these forms
2) Email a copy of the completed forms to helpu2heal@yahoo.com prior to your scheduled appointment
Please note, a new COVID-19 Screening form must be completed prior to EVERY appointment.