Patient Forms

Get ready for your visit

Please download and complete the appropriate forms before your appointment. Contact us if you have questions.

Complete before your first visit so we can get to know you.

Authorizes insurance benefits to be paid to the clinic and acknowledges our HIPAA privacy practices.

Authorize us to discuss your medical information with a family member or another designated person.

Authorize Holy Family Catholic Clinic to release your medical records to an outside provider.