Simply download any of the following editable pdfs, fill them out and print. Bring completed forms with you to your appointment.

  • | .pdf | Patient Demographic Form 

  • | .pdf | Authorization for Verbal Communication and/or to Leave a Voice Mail Message

  • | .pdf | Adult Health Questionnaire

  • | .pdf | Pediatric Health Questionnaire

  • | .pdf | Obstetrical Questionnaire

Personal & Authorization Forms

New Life Clinic

118 3rd St SE

Huron, SD 57350

For Life-Threatening Emergencies Call 911

© 2020 Proudly created for New Life Clinic by This Life Legacy

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