Patient Forms

All forms are in a digital and secure format.
Simply locate the form required, fill it out on your device and click the submit button!

New Patient Packet – English

New Patient Packet – Español

New Patient Packet (Bartlesville Clinic) – English

New Patient Packet (Bartlesville Clinic) – Español

New Patient Packet (Pheasant Ridge – Garnett) – English

New Patient Packet (Pheasant Ridge – Garnett) – Español

Demographic/Consent to Treat – English

Demographic/Consent to Treat – Español

Release of Information – English

Release of Information – Español

Permission to Verbally Share Health Information – English

Permission to Verbally Share Health Information – Español

Financial Assistance – English

Financial Assistance – Español

Demographic/Informed Consent – English

Demographic/Informed Consent – Español

Demographic/Consent to Treat Kansas – English

Demographic/Consent to Treat Kansas – Español

Demographic/Consent to Treat Oklahoma – English

Demographic/Consent to Treat Oklahoma – Español

Behavioral Health Demographic/Informed Consent – English

Behavioral Health Demographic/Informed Consent – Español

You can call us 7 days a week and speak to one of our experienced, friendly staff who will be able to help you.

Our communication center is open:

7:00am – 7:00pm
Seven Days a Week