Health Sphere Wellness Center

Paperwork

To save time on your first visit, please consider reviewing and completing your paperwork ahead of time. The forms are provided below. Please print them, fill them out, and bring them with you on your first visit. Do not hesitate to contact us if you have questions about the forms. If you are on Medicare, there is an additional form that will be required. Our friendly staff will provide this form for you during your first visit.

A doctor's order is required. Please bring these completed forms along with your doctor's order to the first visit.

  • Patient Information Word | PDF
  • Authorization to Referring Doctor (Doctor's order along with this form) Word | PDF
  • Health History Word | PDF
  • Family History Word | PDF
  • Consent of Treatment Word | PDF
  • Notice of Privacy Practices Word | PDF
  • Natural Health Suggestions Word | PDF
  • Permission to Treat a Minor Word | PDF