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Patient Resources & Forms

Welcome to Our Patient Resources

At Total Healthcare Clinic, we make it simple for patients to access important healthcare forms and resources. To save time during your visit, you can download, complete, and bring these forms with you or submit them online when available.

Comprehensive Patient Intake & Consent Form

Required for new patients. Provides personal details, medical history, and treatment consent to help us prepare for your care.

Fill Up Form

Doctor’s Note Request Intake Form — Dossier

For requesting a doctor’s note for work, school, or other needs. Ensures quick and accurate processing.

Fill Up Form

Medication Refill Request Form — Dossier

Use this form to request prescription refills. Helps prevent delays and keeps your treatment on track.

Fill Up Form

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1-(954) 300-2404

Please allow up to 24-hrs for a response from our staff.

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