Forms / Downloads

Online Forms

If you need to make a payment. Please select your payment option and click "Buy Now". 

Cash Payment Price





We are now serving patients in Indiana. You can find the necessary PDF forms at the links below. 

Consent Form - Indiana
Consent Form - Indiana (Spanish)
Whats Your Cost - Indiana
Whats Your Cost - Indiana (Spanish)



  • Great job. We are so happy for the follow-up care for our students.

    - Karla Simmons
    Nurse Egyptian Community