Will this be your first visit at On Demand Immediate Care? Welcome!
Our patient registration forms are located here if you would like to fill them out before arriving for your appointment. Please note, you are not able to submit these forms to us electronically. After filling out the appropriate forms, please bring them with you to your appointment, along with your insurance card and photo ID.
*All Patients must read and/or sign the privacy documents noted by the asterisks below.*
*Patient Registration Information
*Personal Medical History
*Protected Health Information Patient Preferences
*Notice of Privacy Practices
If you have questions about, or would like assistance in completing any of these forms, please call our office at (330) 623-6660.