New Patient Forms

NEW PATIENTS Main_image_kim

 

Welcome to Clinix!

Let us help you get the most out of your first visit.

Preparing For Your First Medical Visit:

Before your Visit:
Click to Fill Out These Online Forms AND Print & Fill Out

PREVENTIVE WELLNESS VISITS ~ Please fill out prior to your Preventive Wellness Visit:

PARENTS please fill out if your child is a new patient (AGES 0-17):

Please Fill out if you are AGE 18-64: (2 online forms)

Print & Fill out if you are AGE 65+ OR a Medicare Patient:

THANK YOU FOR FILLING OUT BOTH COLUMNS OF FORMS.

Additional Forms Fill if requested by staff or relevant to your visit:

At Your Visit:

  • Bring printed & completed forms
  • Bring photo ID and Insurance card
  • Bring a list of current medications
  • Bring any questions for your provider
  • Bring a list of specialists that you currently see

Additional Forms

Please fill out upon request

For your safety and convenience, Clinix has wheelchair and ramp accessibility. 

Please notify us prior to your appointment, if you need assistance.