Clinic Forms & Documents

Immunizations

  • Adult Immunizations Schedule
    • View the recommended immunizations and at what age to receive them according to the CDC.

  • Travel Questionnaire  
    • Are you traveling out of the country and need to be sure you have the recommended and required vaccines? Fill out our travel questionnaire and our team will review it and get you scheduled for your travel clinic appointment. 

General 

Health Information Exchange 

Medical Records 

  • Demographic Change Request
    • The Demographic Change Request form can be used to change information on your medical records for reasons such as marriage, divorce, court order/naturalization, or misspellings.
  • Patient Right of Access (Spanish) (Records Request Form) Please email a copy of your photo  ID with the request.
  • Patient Right of Access (Records Request Form) Once you complete the form, check your email and click the link to sign the form electronically.  For Validation and consent, once signed, a photo of the patient's ID (front and back) will be required for submission.
    • If you’ve been at the health department for services and need information or records regarding those services, fill out the Patient Right of Access to allow the health department to release those records to you or a facility of your choice. 

HIPAA