Please print and complete the forms below (as requested by your provider) and bring with you to your appointment.

Patient Registration Form (to be completed by all new patients)

Adult History Questionnaire

Child and Adolescent History Questionnaire

Geriatric (Senior Person) Form

Addiction Clinic New Patient Questionnaire (Dr. Elizabeth Foote)

  •  Adobe Reader is required to read and download forms. ​Click below to download Adobe Reader.   Image result for adobe reader

  • Once a link is opened, a bar (see below) will appear at the bottom of the page to allow you to download and save or to print the forms for completion.

            Save Print

Image result for additional resources

For questions and further information,
please call (405) 271-5251.