Patient Forms

Patient Forms for your visit (except for those only coming in for a flu shot):

Patient Registration Form
NUC/BUC Health History Form
BUC Telemed Consent Form
Financial Agreement

Forms for unaccompanied minors (under the age of 18):

Authorization to Treat a Minor

For those patients coming in for a Flu Shot:

Influenza Vaccine Consent Form  (please also read:  Influenza Information Sheet)

For those patients requesting a release of Health Care information:

Authorization to Release Health Care Information