New to The Center for Physician Wellbeing? Fill out and print the forms below to save time on your first visit.

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Client Personal and Medical Information

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Informed Consent

• Physicians

• Residents

• Advanced Practice Providers

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If your child will be meeting with a CPW counselor, please read and sign the forms below in addition to completing the Client Personal and Medical Information form.

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Parent/Guardian Informed Consent

Minor Assent Form

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Please look over our Privacy Policy before your first visit.

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