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