Registration Forms
We want to make your registration at any IHA urgent care as easy as possible. For your convenience, you may download and complete the Patient Registration form prior to coming to the urgent care. You will also find a copy of your Notice of Privacy Practices and commonly used forms for the Bureau of Worker's Compensation and Ohio High School Athletic Association.
*Please bring a list of current medications to your visit.
Download and Complete
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Patient Registration
This form will need to be completed upon your arrival at any of our facilities. This form allows you to give detailed information about your current health and background so our health professionals can provide the best care suited for you.
Notice of Privacy Practices
At our Immediate Health Urgent Cares we understand that your information is highly personal and we are committed to safeguarding your protected health information.
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Bureau of Worker's Compensation
This form is used to report an injury, occupational disease or death that occurred at your place of work.
Ohio High School Athletic Association
Whether your child is getting ready for sports, school or camp, a physical is the first step in making sure they’re healthy and ready for activity.