Forms

Are you a new patient?

If so, please download and fill out the following forms before your first appointment.

• Patient Registration Form, Fenway Health (PDF)

• Inscripción del cliente (PDF)

• Patient Registration Form, Sidney Borum, Jr. Health Center(PDF)

• Guarantor Form (PDF)

• Formulario de garante financiero (PDF)

• Medical Records Release Form (PDF)

• Patient Rights and Responsibilities

• Preventive Care Versus Diagnostic Care (PDF)

Are you a returning patient?

In order to keep our records up-to-date, we ask that you complete this form once per year.

• Returning Patient Form, Fenway Health (PDF)

Are you a new dental patient?

If so, please download and fill out the following forms before your first appointment.

• Patient Registration Form (PDF)

• Inscripción del cliente (PDF)

• Guarantor Form (PDF)

• Formulario de garante financiero (PDF)

• Medical History Form (PDF)

• Formulario De Historia Clínica (PDF)

• Appointment Cancellation Policy (PDF)

• Política de Cancelaciones (PDF)

• Patient Rights and Responsibilities

Are you a returning dental patient?

Please fill out this form before your appointment if you haven’t already done so this calendar year. In order to keep our records up-to-date, we ask that you complete this form once per year.

• Returning Patient Form (PDF)

Are you a new optometry patient?

If so, please download and fill out the following forms before your first appointment.

• Patient Registration Form (PDF)

• Inscripción del cliente (PDF)

• Optometry History Form (PDF)

• Guarantor Form (PDF)

• Formulario de garante financiero (PDF)

• Appointment Cancellation Policy (PDF)

• Patient Rights and Responsibilities

Are you a returning optometry patient?

Please fill out this form before your appointment if you haven’t already done so this calendar year. In order to keep our records up-to-date, we ask that you complete this form once per year.

• Returning Patient Form (PDF)

• Optometry History Form (PDF)

• Appointment Cancellation Policy (PDF)

Are you a new patient?

If so, please download and fill out the following forms before your first appointment.

• Patient Registration Form, Fenway Health (PDF)

• Inscripción del cliente (PDF)

• Guarantor Form (PDF)

• Formulario de garante financiero (PDF)

• Patient Rights and Responsibilities

Are you a returning patient?

In order to keep our records up-to-date, we ask that you complete this form once per year.

• Returning Patient Form, Fenway Health (PDF)

Fenway Hormonal Treatment Documents

• Informed Consent for Feminizing Therapy

• Consentimiento informado para tratamiento hormonal feminizante

• Informed Consent for Masculinizing Therapy

• Consentimiento informado para tratamiento hormonal masculinizante

• Informed Consent for Hormone Blockers

Find more information on Transgender Health Program services and resources here.