Patient Forms

PARDON OUR DUST: WE ARE ACTIVELY WORKING TO MAKE MORE SECURE FORMS AVAILABLE TO YOU ONLINE, DURING THAT PROCESS THIS PAGE MIGHT LOOK POORLY FORMATTED. 

We are happy to provide our office forms for convenient online secure submission. Questions about which forms you need to fill out? Please call our office and our staff will assist you in preparing for your visit.

New Patient Forms:
Please fill out prior to your first appointment. 
Now available online! 

Well Visits Forms:
Save time at your visit! Click on the links below and fill out the developmental screeners and health history updates electronically, it will be sent to our office securely and ready for your visit!
Now online! 


Mental Health Visits:


Asthma Visits:

In order to view or print these forms, you will need Adobe Acrobat Reader installed. Click here to download it.

South Royalton Health Center

79 S Windsor St, PO Box 119 South Royalton, VT 05068

Office Hours

Mon-Fri: Phones open at 8:00 AM, visits start at 9:00AM. Closed from 12-1 for lunch, voicemail only during lunch hour. Open until 4pm due to covid/summer hours.
On-Call Clinician available afterhours and on weekends, call main number to page.