• Health Assessment Questionnaire
  PDF format.
• Health History Form
  PDF format.
• Consent for Treatment
  This form gives consent for the medical staff at Partnership Health Center to examine and render care. PDF format.
• Authorization for Release of Protected Health Information
  This form grants authorization for the release of protected health information. PDF format.
• Flu Vaccine Questionnaire
  This questionnaire / consent form will help determine if you are a viable candidate for the flu vaccine. PDF format.

For Your Information

• Current Drug List
  A current list of medications that will be initially offered at the Partnership Health Center. PDF format.
• Notice of Privacy, Policies, and Practices
  This notice describes how information about you may be used and disclosed and how you can get access to this information. PDF format.
• Flu Vaccine Information
  What you need to know about the inactivated influenza vaccine. PDF format.
• Flu Shot Fridays
  Information on receiving your flu shot during Flu Shot Fridays at the Poland Spring Arena.