Patient Forms

Please print and fill out the new patient forms for the doctor you are seeing.

New Patient / Family History Form

Health Information Disclosure Form

Financial Policies Form

Release of Medical Records Form


Click here for a list of accepted insurance plans. Please bring your current insurance card to your appointment.

Important Information

Thank you for choosing WRHPI as your healthcare provider. Please feel free to print, read, and complete the available forms prior to your visit. Having the forms completed upon arrival will save time during check-in and provide you with a better understanding of our policies and procedures.