17 May, 2025
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Patient Information

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HIPAA Compliant Online Forms

Please select the lists of forms from below that  you would like to fill out.

Medical Weight Loss Program Intake Form
Indemnification Clause
Patient Medical History Form
Telemedicine Informed Consent
Credit Card Authorization Form
Consent to Treat Form
New Patient Registration Form
HIPAA agreement form - Health care operations.

Telehealth / Video Visit

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Optimized Wellness provide high-quality, compassionate and affordable medical care to both insured and uninsured patients. We provide medical care in the comfort of your home through telehealth/video visits and house calls. [….]

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