New Patients Forms

When you arrive for your first appointment at Centerpoint Health, we want to get to know you first. You will be asked to complete several forms prior to being seen by your provider. To get a head-start on these forms, please click here  to access the Intake Packet.  Print, complete, and bring these forms with you 20 minutes before your first appointment. If you would like assistance completing any of this information, our staff will be available to help. 

Other Forms

Other forms which may be relevant to your care at Centerpoint Health which are made available here for your convenience.


 Our Welcome Letter is to give our new patients a brief overview of our patient-provider relationship.  Click here  to download the Welcome Letter form. 



Release of Information (ROI) is a form in which we require all new patients to fill out.  This form allows our providers to receive your past medical history from previous providers, hospitals, urgent cares, and even specialists that you may have been seen by.  Having these previous records will help us ensure that we develop the best plan of care for each individual patient. 

Click here to download the ROI form. 

Click here to download the ROI form if you are the patient and want to give us authorization to release your records to you or someone else. 



Our Transition Letter is required to be signed by all patients who are between the ages of 12-14.  This letter explains how Centerpoint Health is here to help the youth transition from a "pediatric" patient to an "adult" patient.  We want to ensure we help these patients become more independent with their health care by taking the time to educate them one-on-one. 

Click here to download the Transition Letter.