Patient In-Take Packet
Minor Consent Form
BGSU Firelands Patient Packet
Edison Local Schools Patient Packet
Huron Local Schools Patient Packet
Monroeville Local Schools Patient Packet
Margaretta Local Schools Patient Packet
Sandusky City Schools Patient Packet
Townsend Community School Patient Packet
Vermilion Local Schools Patient Packet
Western Reserve Local Schools Patient Packet
Sliding Fee Scale Application
Request for Transcript of Tax Return
Authorization to Release Medical Records
HIPAA Authorization Form
Patients Rights and Responsibilities
Patient Privacy Notice