Download Forms

To save time before your appointment at WellOne, please download and complete the forms below ahead of your visit. If you’ve recently been to one of our locations and have already filled out these forms, there’s no need to complete them again.

Welcome Packet

Adult Health History Form

Child Health History Form

For Your Next Visit

Adult Dental History Form

Child Dental History Form

Application For Reduced Fee Services

Medical Records Release Authorization Form

Dental Medical Release Form

HIPAA Notice of Privacy Practices

Patient’s Rights and Responsibilities

Your Right to Receive a Good Faith Estimate