Patient forms


Patient Intake Form

Are you a new patient of Orleans Family Health Clinic?
All new patients of the clinic are required to fill out a patient intake form.

Patient Intake Form

OFHC Pediatric Health Questionnaire

Please download and fill out the Pediatric Health Questionnaire.  Please bring in the form with you at your first appointment with the pediatrician.

OFHC Pediatric Health Questionnaire

Authorization of Record Release

This form gives Orleans Family Health Clinic permission to release health information to ensure you are receiving the proper care.

Authorization of Record Release

Patient Enrollment Form FHG

For new patients to the clinic that require enrollment with one of our doctors.  Please print and complete the form and mail it to our office address or drop it off at the clinic.  Please ensure you have done your COVID Screening prior to arrival at the clinic.

Patient Enrollment Form FHG

Patient Forms
Ambulance-Icon

EMERGENCY? CALL 9-1-1

If you have a life-threatening medical emergency, contact 911 immediately!

Dial 911 to call an ambulance. Calling this number is free from any phone. Once in contact with the 911 operator, notify them of any health problems you or someone you know is facing. They will be able to evaluate the urgency of the situation and send an ambulance if needed.

For non-life-threatening conditions, same day emergency appointments are available with your doctor. (Please note that same day emergency appointments MUST be booked in the morning.)

After hours or on holidays, please call Telehealth Advisory (1-866-797-0000) to speak with a registered nurse. This service is free, confidential and available 24/7.