Patient Forms

If you are interested in becoming a new patient within our Logan University Health Centers, please use the forms below, provided for your convenience. The Notice of HIPAA Privacy Practices form is for you to keep.

New Patient Form

New Patient Health Questionnaire

Radiology Informed Consent Form

Notice of HIPAA Privacy Practices

Acknowledgement of Receipt - HIPAA Privacy Practices

Authorization to use and/or disclose health information Form