Online Forms

Haque Wellness Center offers our patient form(s) online so they can be completed in the convenience of your own home or office.

  • If you do not already have AdobeReader® installed on your computer, click here to download.
  • Download the necessary form(s), print it out and fill in the required information.
  • Fax us your printed and completed form(s) or bring it with you to your appointment.

New Patient Health History Form - Required

This lets us know the history and current state of your health. What questions, concerns, goals, regarding wellness can we help you with? Let us know!

Download & Print Form

New Patient Paperworks

Download & Print Form


Download the Free Adobe Reader®

Location

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Office Hours

Our Regular Schedule

Primary Office

Monday

9:00 am-12:00 pm

3:00 pm-6:00 pm

Tuesday

Closed

Wednesday

9:00 am-12:00 pm

3:00 pm-6:00 pm

Thursday

3:00 pm-6:00 pm

Friday

8:00 am-12:00 pm

Saturday

Closed

Sunday

Closed

Primary Office

Monday
9:00 am-12:00 pm 3:00 pm-6:00 pm
Tuesday
Closed
Wednesday
9:00 am-12:00 pm 3:00 pm-6:00 pm
Thursday
3:00 pm-6:00 pm
Friday
8:00 am-12:00 pm
Saturday
Closed
Sunday
Closed