Queen's Health Centers - Premier Wellness Place for the Whole Family
Forms to bring to your FIRST appointment
 
 
Please note all forms and applications are in PDF format, hence it is necessary to print them out and fax them to QHC II prior to your appointment or bring them with you if you are coming to the appointment in person. 
 
Fax #: 215-721-8836
 
Client Consent Form
Please fill out this form before your 1st appointment
 
 
 
Health Questionnaire
Please fill out this form before your 1st appointment