COVID Vaccines: MAHEC community pharmacies can administer the COVID vaccine to patients 18 and older without a prescription. Patients 18-64 require a high-risk condition that is documented through a self-attestation form available at the pharmacy. Patients 65 and older do not require an attestation.

Watch for more information about vaccine availability in our clinics in the coming days!
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Dentistry and Oral Health

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Patient Forms

New & Established Patients
English Español
Sliding Scale Application
English Español
Privacy Practices and Bill of Rights
English Español
Medical Records Release Form - Incoming to MAHEC
English Español
Medical Records Release Form - Outgoing from MAHEC

Note that a fee will be charged if you are requesting the records for yourself. There is no charge for sending records to another facility.

English Español
Who May We Speak With? (HIPAA Release)
English Español Russian Vietnamese

Provider Forms

General Referral Form OR Referral Form Oral Medicine Referral Form CBCT/3D Imaging Referral Form
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