Pre-vaccination Checklist for COVID-19 Vaccines:

• CDC Pre-vaccination Checklist ​[download]

Patient Registration:

• Patient Registration Form [download]
• Patient History Form [download]
• Consent to Treat Form [download]
• Over 18yr Consent to Treat Form [download]
• Privacy / HIPAA Notice [download]
• CWP Financial Policy [download]

Medical Records:

• Release of Health Care info (incoming) [download]
• Authorization to Release Records (outgoing) [download]

Miscellaneous Forms

• Prenatal Visit Info Form [download]
• KHSAA Sports Form – High School [download]
• KHSAA Sports Form – Middle School [download]

Flu Vaccine/Flu Clinic

• Parent Vaccine Registration Form [download]