Patient Information & Forms

Please download, print, and complete the following Adobe Acrobat PDF forms:


New Patient Registration & Financial Policy form
All new patients must complete this form to set up an individual account with Family Wellness Center. Bring completed form along with your insurance card with you to your first appointment.


Adult New Patient Form
All NEW adult patients must complete this form and bring it to their first office visit appointment.


Children & Teens Under Age 18 form
A parent of a NEW pediatric patient should complete this form and bring it to their child’s first appointment at Family Wellness Center.


Annual Physical Form
Adult patients scheduled for a complete physical exam should complete this form and bring it to their appointment.


Medical Records Release TO Family Wellness Center
If you are requesting that your records come TO Family Wellness Center

What’s Happening

11/13/14 BAD WEATHER UPDATE

The FAMILY WELLNESS CENTER will be closing early on THURS Nov 13th at 4pm.  W

11/04/14 FWC is Sponsor of Northwest Battle Buddies

In honor of Veterans Day and the upcoming holidays, FWC will be collecting don

11/04/14 THANKSGIVING WEEK SCHEDULE

Our THANKSGIVING WEEK Schedule is