In an effort to conserve paper, all of the signatures acknowledging that you have read the forms have been condensed into one page. Therefore, only the welcome form and the signatures form need to be printed out and brought with you to the visit. If you would prefer to fill them out at the clinic, please arrive 15 minutes early to do so.
Please read these forms before your visit:
Please fill out these forms before your visit:
Please read these forms for your child or dependent before his/her visit:
Please fill out these forms for your child or dependent:
If you would like to have your records sent from another doctor to Healing Breeze please fill out and sign this form: Medical Records Request Form–to HB
If you would like Healing Breeze send records to another doctor please fill out and sign this form: Medical Records Release Form HB to other