HealtheConnections Consent Part of new patient packet Records Release to CFCLC Use to obtain records from another office for use by CFCLC Records Release from CFCLC Use to release records from CFCLC to another office Pediatric Health History For patients under the age 16 Request for Amendment Request changes to your medical record Adult Health History Required for adult new patients Adult Demographic Intake Part of new patient packet Pediatric Demographic Intake Patients under the age 18 NYSIIS Consent For all patients aged 19+ years PHQ9 New Patients New patients (age 15+) CFC Brochure PCMH Brochure Welcome Letter For all patients Consent HIPAA and Office Policies Required for new patient packet Pediatric Consent HIPAA and Office policies Pediatric Consent HIPAA and Office policies (under the age of 18) Employment Application