For Patients

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Patient Forms

New Patient Forms

New patients may print, fill out, and bring these papers with them to save time at check-in. For adult and pediatric patients.

View Form

Release of Records

Existing patients may fill out this form to request that Highlands Healthcare share their health information with another physician.

View Form

What to Bring

Help us better understand your health.

  • List of current medications (or bring the bottles)
    Photos of the bottles work too.
  • List of daily vitamins and supplements
    These are things you take by mouth in addition to food, like minerals, amino acids, and herbs or botanicals.
  • Medical records including dates of surgeries
    You can request your medical records from other healthcare providers using the Release of Records form, above. If you don’t have records, a list of major illness and surgeries will be fine.
  • List of complementary and alternative therapies
    This includes things that like acupuncture, homeopathy, massage, chiropractic, and biofeedback. If you’re not if something should be included, mention it anyway. 
  • Journal of symptoms
    Let us know what’s going on with you. When did you start feeling ill or get injured? 
  • List of questions you have about your health
    We’re here to foster your health. That includes keeping you informed and answering your questions.


Get information about our insurance and cash options


Highlands Healthcare follows HIPPA regulations for the privacy of your medical information.