Patient Forms

You can fill out the forms in your web browser or using Adobe Reader.

If you are using your browser, select the print option when you are done, in the printer destination dropdown choose the Save as PDF option so it saves the text you enter into the form fields.

If you are using Adobe Reader please make sure that you are using the most recent version to ensure we receive your PDF's correctly. You can download it for free here.

When you are done you can email them to us at shepherdhealth11@yahoo.com.

New Patient Paperwork

Fill in all relevant fields. You can disregard the signature fields, we will have a printed copy for you to sign when you come in for your appointment. Once you are done, you can save the document and email the form back to us or print them and bring them with you to your appointment if you prefer. Please be sure to make your appointment BEFORE sending us the paperwork.

If you are using your browser, select the print option when you are done, in the printer destination dropdown choose the Save as PDF option so it saves the text you enter into the form fields.

If you are using Adobe Reader please make sure that you are using the most recent version to ensure we receive your PDF's correctly. You can download it for free here.

We look forward to serving you at Shepherd Healthcare!

New Patient Paperwork >

New Patient Paperwork - Spanish >

Payment Plan Arrangement

If you would like to set up a payment plan to help make your balance manageable, please submit this form to our office for review and we will follow up with you to confirm the arrangement.

Fill in all relevant fields. You can disregard the signature field for now, we will have you sign later.

If you are using your browser, select the print option when you are done, in the printer destination dropdown choose the Save as PDF option so it saves the text you enter into the form fields.

If you are using Adobe Reader please make sure that you are using the most recent version to ensure we receive your PDF's correctly. You can download it for free here.

**Please NOTE: Submitting this form does not guarantee a payment plan. Please wait until we get in touch with you to confirm.

Payment Plan Form >