We are excited to announce the opening of our School Based Health Clinic. We are now accepting appointments. All required forms can be found at the following links: 

Pediatric Intake Form

Consent to treat a minor

Registration Form (if you are a current Logan Health Patient, you do not need to complete this form.) 

Consent & Release of Information

Please include a copy of your insurance card. 

These forms can be returned to your child's school or emailed to nicki.sullivan@conradschools.org

RELEASE OF INFORMATION

To be completed if the school needs to contact your healthcare provider (outside of Logan Health) to exchange information. 

Release of information form