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. Our friendly staff will be happy to assist you.

We are now Direct Access; however, please check with your insurance coverage to see if a doctor's order is required. If you are a Medicare patient, a doctor’s order is required. Please bring these completed forms along with your doctor's order (if required) 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
  • Medicare Patient Word | PDF
  • Permission to Treat a Minor Word | PDF
  • Notice of Privacy Practices Word | PDF
  • Natural Health Suggestions Word | PDF