FORMS

NEW Patients: Please Download and Complete FORMS 1-4

FORM 1 Consent to Receive Treatment

FORM 2 Payment Policy

FORM 3 Consent to Use and Disclosure of Protected Health Information

FORM 4 Authorization To Release Medical Information to PHA

FORM 5 Notice of Privacy Policy

FORM 6 Patient Portal Use Policy

FORM 7 Medical Marijuana Consent Form - to be signed after the evaluation with the doctor.

FORM 8 Authorization To Release Medical Information from PHA