Lodge Wellness Center
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Forms for NEW PATIENTS

IMPORTANT:
For your convenience, please complete your new patient paperwork before your clinic visit. You may print the forms and complete them by hand or download the forms to your computer and complete them electronically. If you complete the forms electronically, you can print them and bring them to your clinic appointment. Alternatively, you can email them to patientserviceslodge@121.health, and we will print them for you and have them ready for your signature at your appointment. Please note that you must sign and date each form by hand.

New Patient Forms: Adult
Medical Release Form

FOR MINORS ONLY
New Patient Forms: Minor

PRE-EMPLOYMENT FORMS
PRE-EMPLOYMENT FORMS
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  • Home
  • Services
  • Clinic & Contact Info
  • Team
  • FORMS FOR NEW PATIENTS