Intake and Consent Forms

New Patient Intake and Consent Forms

Thank you for choosing me to help address your health concerns. All new patients are asked to download and complete the appropriate Intake form, as well as the Consent to Treatment form prior to the arrival for their first appointment. This will help to provide a more accurate picture of your health history.

Adult intake

 

 

Adult New Patient Medical Intake Form

Adult new patients are asked to complete this form. Please bring it to your initial visit so that Dr. Halldorson can review your current concerns and past health history together with you.

 

Ped Intake

 

 

Pediatric New Patient Medical Intake Form

Parents of new pediatric patients are asked to complete this form. Please bring it to your initial visit so that Dr. Halldorson can review your child’s current concerns and past health history.

Consent form

 

 

Consent to Treatment Form

Please read through and sign the consent forms prior to your first visit. Parents, please complete this form on behalf of your child. All new patients who are minors must have their parent or legal guardian sign these forms.