Advanced Urgent Care
Advanced Urgent Care
Patient Forms

Welcome to HealthCare Partners! We thank you for choosing us as your partner in health. To help you save time, we have the following forms available for you to fill out prior to your next appointment.

If you are a new patient, please take a moment to print and complete the forms below.

If you are an established patient and you would like to update your information, you may print and complete the applicable form(s) below.

Please bring the completed forms with you to your HealthCare Partners appointment.

Patient History

Patient Registration

Authorization for Use and Disclosure of Protected Health Information

HIPAA Contact Disclosure

HIPAA Notice of Privacy Practices (Acknowledgement)

Well Being Assessment Form

HIPAA Notice of Privacy Practices (Patient Copy)
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Advanced Urgent Care
Advanced Urgent Care
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