Forms

Adult Health Registration Packet: English Version | Spanish Version

Assistive Technology Registration Packet: English Version | Spanish Version

Assistive Technology School Registration Packet: English Version | Spanish Version

Behavioral Health Registration Packet: English Version | Spanish Version

Consent for Disclosure of Protected Health Information (PHI) Form: English Version | Spanish Version

Dental Registration Packet: English Version | Spanish Version

Early Intervention Forms and Documents (please see right side of the page)

Request Medical Records (Clinical)

Request Early Intervention Records

Speech Registration Packet: English | Spanish

WIHD Patient Portal Request Form: English | Spanish