For Patients
Find the forms and notices you need for your visit. Have a question? Our front desk is happy to help.
New Patient Packet
These forms are available at our front desk. You can also call us or email us to get them.
- New Patient Check List
- Authorization for Treatment
- Authorization for the Treatment of Minors
- Authorization to Release/Obtain Protected Health Information
Download these now:
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Patient Bill of Rights (PDF)
English
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Patient Bill of Rights (Spanish, PDF)
Español
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Notice of Privacy Practices (PDF)
English
-
Notice of Privacy Practices (Spanish, PDF)
Español
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HealthShare Exchange Consumer Brochure (PDF)
Learn how your health information is shared between providers.
Patient Update Packet and Other Documents
Current patients may be asked to fill out a Patient Update Packet. These documents are available at our front desk, or by call or email:
- Patient Update Packet
- Patient Standards of Conduct
- Patient Privacy Notice/HIPAA
- Patient Bill of Rights
- Permission to Share Patient Information
Need a form? Ask our front desk, call 215-471-2761, or email info@spectrumhs.org.
No insurance? You can still get care. Ask about our sliding fee discount program. It lowers your cost based on your household size and income.
Ready for Your Visit?
Make an appointment, or walk in at any of our health centers.