Patient resources
Patient and employer forms
Bring any school, sports, employer, or occupational health forms that need to be completed. Requirements differ by organization.
At a glance
- Bring the original required form
- Complete your portion before arrival
- Bring identification and relevant records
- Call if you are unsure what is needed
What to know
No medical information is collected here
For privacy, this public marketing site does not accept form uploads or medical information. Contact the clinic for instructions if an organization requires special paperwork.
Download clinic forms
Print the forms relevant to your visit and bring them to the clinic. Do not send completed forms, medical records, Social Security numbers or payment details through this website. Ask the clinic for any additional health-history or vaccine paperwork needed for your visit.
More about Workplace Forms
Authorization to Treat Form
If you are sending an employee in to Newport Urgent Care for any sort of treatment, please complete this form.
Download and Print Form
WorkComp Insurance Information
If you are sending an employee in to Newport Urgent Care for a workplace injury, please complete this form.
Download and Print Form
Commercial Driver Fitness Determination
If you are sending a Commercial Driver for a Medical Examination Report to determine fitness, please complete this form.
Download and Print Form
In order to release Health Care information, the following form must be filled out:
Authorization to Release Health Care Information
New-patient paperwork and privacy information
Call the clinic for its current new-patient packet and Notice of Privacy Practices. Keep your medication list, allergy information and relevant history available for the clinical team. Do not send those details through this website.
- Ask which registration, history and treatment-consent documents are needed
- Ask for financial responsibility and self-pay estimate information
- Request the current records-release form if you need to transfer records
Children, school and sports visits
Bring the current form supplied by the school or sports organization. Ask the clinic which guardian or authorization documents apply to the visit; requirements can differ by the care being requested.
Employer and occupational health visits
Bring the employer’s authorization, requested service list and any work-injury or examination paperwork. Confirm the exact DOT or non-DOT requirements before arriving, rather than using an old form found online.
Keep completed forms off the public website
Bring completed paperwork to the clinic, or follow a separately confirmed clinic-approved secure process. This site does not accept uploads, completed medical forms or patient records. Do not return medical forms by ordinary email.
Need care now?
We’re ready to help you plan your visit.
For a life-threatening emergency, call 911.