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Forms

Use the links below to print copies of our most frequently used forms. All forms are in a PDF format. If you don't already have Adobe Acrobat Reader^TM, you can download it free.

Important Update for Patients: Beginning April 1, 2010, a small fee may apply for Lifetime Health to complete certain forms on your behalf. Any required payments are due at the time the request is made.

Download Adobe Acrobat Free

To obtain forms not listed here, please contact your Lifetime Health Health Center or primary care physician's office.

Advance Care Planning
Easy to use manual for future medical care in case you are unable to make your own decisions. Available in both English and Spanish.

Forms Completion Request
Please use the forms completion request to accompany any form that you need our office to fill out for you or your child, including immunization records requests, school and daycare forms.

Medical Records Release Form
Please complete this form to give Lifetime Health permission to release your medical records to another provider.

Minor Consent Form
For pediatrics patients. Please fill out and sign prior to the visit if your child (under 18 years old) will be coming to his or her visit with an adult who is not parent or guardian or without an adult.

X-ray Image Request
Use this form to request images from X-rays taken at any of the Buffalo area Lifetime Health Medical Group centers.