Patient Forms

For your convenience, patient forms are available for download below. Please print and complete before your visit.

MRHS Clinic forms

NP Registration Form

HIPAA Form

Financial Form

Release of Information

Behavioral Health/Therapy forms

Mental Health HIPAA

Behavioral Health Release of Information

Behavioral Health Financial Policy

Behavioral Health Remote Therapy Notice

Behavioral Health Consent to Treat

To complete your new patient registration electronically, please use the following link.

new patient registration

Midwest Regional Health Services

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