Instructions for completing pre-appointment paperwork:

 

If you are coming to Gentle Care Health Center for an appointment with Ellen Spinner, CNP, you can download and print the required documents prior to your appointment. The documents appear down the left side of this site, and are titled “Health History”, “Patient Information”, “Consent Form”, and “HIPAA Statement“. Please complete all 4 of these forms to the best of your ability, and Darcy will review them with you when you arrive for your appointment. Please note that the signature line at the bottom of the “Patient Information” is stating that you have reviewed the “No Show Policy”; please be sure to review that before signing.  It is also listed on the left side of this site.

 

If your appointment is for a scheduled sports or camp physical, please print and complete the OHSAA physical forms. Please be sure to have a parent sign this form in the space provided specifically.

 

Also, please bring with you your health insurance card, any office visit co-pay listed on your card, and your driver’s license.  If you do not have health insurance, please note that payment is due in full at the time of service.

 

 

Thank you.

 

 
 
 




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