RESOURCES

RESOURCES

PATIENT PAPERWORK

Access our paperwork online! All documents are in PDF format and can be read, saved, or printed by using most popular web browsers, such as Google Chrome.

New Patients - Complete the Three Forms in the Red Outlined Sections

Print the following forms then scan or take a picture of your completed paperwork and email it to us along with your name and date of birth to info@integracareclinics.com.

Patient Intake Form

This paperwork asks about your symptoms that you will be seen for during your appointment.

Consent to Treat

This consent to treat must be signed prior to receiving care at the clinic. 

Patient Notice

This notice must be signed prior to receiving care at the clinic. This is our HIPAA paperwork.

Release of Information Forms

If you are an existing patient or new patient needing to send in your medical records, you may have been asked by a staff member to complete one of the following forms.

Print the following forms then scan or take a picture of your completed paperwork and email it to us along with your name and date of birth to info@integracareclinics.com

Sending Records OUT of Integracare

To be completed when requesting Williams Integracare send the information to another medical facility. 

Sending Records INTO Integracare

To be completed when sending information to Williams Integracare from another medical facility.

Phone: (320) 251-2600
Email:
info@integracareclinics.com

Copyright 2021, Integracare LTD, All Rights Reserved. Information on this website should not be regarded as medical advice.