EPB EMPLOYEE HEALTH CENTER
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Forms for New patients 

For your convenience, please complete your new patient paperwork before your clinic visit. You may print the forms and complete them by hand or download the forms to your computer and complete them electronically. If you complete the forms electronically, you can print them and bring them to your clinic appointment. Alternatively, you can email them to patientservicesepb@121.health, and we will print them for you and have them ready for your signature at your appointment. Please note that you must sign and date each form by hand.
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New Patient Forms: Adult
Medical Release Form
Lab Consent Form
For minors only: 
New Patient Forms: Minor
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  • Home
  • Clinic Information
  • Services
  • Health Coaching
  • Telehealth
  • PATIENT PORTAL
  • FORMS FOR NEW PATIENTS
  • Resources
  • Team