Iowa Specialty Hospital

Patient Forms

For your convenience, the forms below are available for download.
 

The Release of Health Information form allows you to request to have your medical records transferred from a previous healthcare facility or provider to Iowa Specialty Hospitals & Clinics.  Please download the form using the link below.

Release of Health Information

 

Please download and complete this form if you would like to pre-register for Counseling & Therapy Services and bring it with you to your first appointment.

Counseling & Therapy Services Patient Form

 

Please download this form if you wish to complete the paperwork for Durable Power of Attorney AND a Living Will.

Durable Power of Attorney and Living Will Form

 

Please download this form if you wish to complete the paperwork for a Living Will ONLY.
 

Living Will Form Only

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