Patient Forms

When we receive your completed forms, they will be processed and one of our staff will contact you to arrange an appointment. If you have difficulty downloading the forms or would like to speak directly with our office staff, please call 484-232-5288

It is important that we have accurate information about you, your medical concerns and medical history. Below you will find downloadable forms that every new or continued patient might need to complete prior to scheduling an initial appointment with Ethos Clinic.

Please fax completed forms to: (570) 392-6143.


Consent Forms for Minors

Download Forms


Adult Consent Forms

Download Forms