Forms

Patient Forms

PWHC Medical Records Release of Info – Allows patients to authorize the disclosure of their health information to a designated individual, company, agency, or facility.

PWHC HIPAA auth to disclose PHI

Preferred Contacts (PDF) – Patients are encouraged to complete and return the Preferred Contacts Form.

Virtual Visit Policy (PDF) – This policy describes the process for the documentation, maintenance, and transmission of information using virtual visit technology.

PWHC Financial and Other Policies

PWHC Dental Letter

Portal Self Check In Guide

Patient Portal Registration Instructions

Glucose Test Instructions

Depression Screening Form