St. Mary's Medical Center | Huntington, WV | (304) 526-1234

Forms and Brochures

St. Mary's is now offering certain medical center brochures and forms online. Our goal to provide the opportunity for you to browse information and fill out paperwork before you arrive. Only a few documents are currently available, but more will be added in the near future. (You will need Adobe Acrobat Reader®to view and print these files.)

Pain Relief Center

Outpatient Center

Weight Loss Surgery Center

Rehabilitation Services

  • Outpatient Rehab Intake Form

    Please fill out all sections of the intake form as completely as possible and bring the completed form with you to your first therapy visit. The therapist will review the information and discuss it with you. Information provided will assist the therapist in performing your evaluation and creating a plan of care specific to your needs. Thank you.

Testing Fact Sheets

 

Medication Record

Please fill out this form including all prescription drugs, over-the-counter drugs, vitamins and herbal supplements. Keep this form with you in your purse or wallet so it is available in case of an emergency and always take it with you to doctor and hospital visits.