Patient Forms

Complete Your Forms Ahead of Your Appointment

For your convenience, we’ve provided the most commonly used patient forms all in one spot! Please take a moment to view, download, print, and complete the appropriate forms for your next visit.

• Consent for Evaluation & Treatment
• Medical Records Release of Information from IMC
• Medical Records Release of Information to IMC
• Patient Consent for Use and Disclosure of Protected Health Information 
• Authorization for Release of Information to Friends and/or Family
• Wender Utah Rating Scale for the Attention Deficit Hyperactivity Disorder
• Payment Policy