Forms

Here are three of our patient forms that we have you fill out with your contact and medical information. You can download them and bring them in with you so you don’t have to spend time filling them out while you’re here. At Village Emergency Centers, we have taken the steps to reinvent the way emergency and urgent care is provided.

Patient Sign-In Sheet

Patient Rights and Responsibilities

Assignment of Benefits and Consent for Treatment

What We Treat

Abdominal pain
Allergic reactions
Altered mental status
Asthma and breathing problems
Bone setting and splinting
Bronchitis
Burns
Cold treatment
Complete pediatric care
Chest pain and heart issues
Dehydration
Flu treatment
Foreign body removal
Head injuries
Overdoses
Pain control
Pneumonia
Rashes
Insect bites and stings
Seizures
Sinusitis
Lacerations
Sprains and broken bones

Pediatric Treatments

Cold and flu
Asthma attacks
Abdominal pain
Ear infections
Allergies
Lacerations
Burns
Conjunctivitis (pink eye)
Infections
Orthopedic injuries
Broken bones and sprains
And More