View cart “Prescription Pad” has been added to your cart. $0.00 Informed Consent and Request for Care quantity Add to cart Category: Forms, Paperwork Additional information Additional information Language Options English, Spanish, Both Related products OHP Application $0.00 Select options Work Release Form $0.00 Select options HIPAA Consent $0.00 Add to cart Referral, Lair Hill Health Center $0.00 Add to cart