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Patient Forms

Please print and complete the appropriate form(s) provided below, and bring them to your appointment. Completing the form(s) prior to your first visit saves time and allows you to complete them at your own pace.

Terms & Conditions

By participating in this quiz, or screening or health assessment, I recognize and accept all risks associated with it. I understand that the program will only screen for certain risk factors and does not constitute a complete physical exam. For the diagnosis of a medical problem, I must see a physician for a complete medical exam. I release Deborah Heart and Lung Center and any other organization(s) involved in this screening, and their employees and agents, from all liabilities, medical claims or expenses which may arise from my participation. Thank you for investing in your health by participating today.