{"id":1155,"date":"2026-05-18T13:45:16","date_gmt":"2026-05-18T13:45:16","guid":{"rendered":"https:\/\/qlogicllc.com\/poncatribe\/?page_id=1155"},"modified":"2026-09-28T12:28:46","modified_gmt":"2026-09-28T12:28:46","slug":"health-forms","status":"publish","type":"page","link":"https:\/\/qlogicllc.com\/poncatribe\/health-forms\/","title":{"rendered":"Health Forms"},"content":{"rendered":"<section style=\"--hero-bg:#0D0F0E;--hero-bg-solid:#0D0F0E;--hero-min-h:580px;--hero-pad-top:0px;--hero-pad-bottom:0px;--hero-pad-x:0px;--hero-max:1504px;--hero-gap:20px;--hero-justify:flex-end;--hero-align:center;--hero-align-items:center;--hero-text-align:center;--hero-eye-gap:14px;--hero-eye-to-title:40px;--hero-title-gap:0.4em;--hero-desc-top:24px;--hero-desc-max:720px;--hero-desc-link:#DEB209;--hero-btns-gap:16px;--hero-btns-top:40px;--hero-bg-size:cover;--hero-bg-pos:center center\" class=\"ponca-hero sec_padding alignfull wp-block-ponca-page-hero\">\n\t\t\t<div class=\"ponca-hero__bg\" style=\"--hero-bg-image:url('https:\/\/qlogicllc.com\/poncatribe\/wp-content\/uploads\/2026\/05\/health-services.jpg');\"><\/div>\n\t\t\t\t\t<div class=\"ponca-hero__overlay\"><\/div>\n\t\t\t\n\t<div class=\"container ponca-hero__container\">\n\n\t\t\t\t\t<nav class=\"ponca-hero__eyebrow\" aria-label=\"Breadcrumb\" style=\"--hero-eye-font-family:&#039;DM Sans&#039;, &#039;Helvetica Neue&#039;, sans-serif;--hero-eye-font-size:13px;--hero-eye-line-height:22px;--hero-eye-font-style:normal;--hero-eye-font-weight:600;--hero-eye-letter-spacing:3px;--hero-eye-text-transform:uppercase;\">\n\t\t\t\t\t\t\t\t\t\t<a class=\"ponca-hero__crumb\" href=\"https:\/\/qlogicllc.com\/poncatribe\"\n\t\t\t\t\t\t   target=\"_self\"\t\t\t\t\t\t   \t\t\t\t\t\t   style=\"--hero-crumb-color:#6e6b6d;\">Home<\/a>\n\t\t\t\t\t\t\t\t\t\t\t<span class=\"ponca-hero__eyebrow-sep\" aria-hidden=\"true\" style=\"--hero-sep-color:#A7A7A7;\">\u2022<\/span>\n\t\t\t\t\t\t\t\t\t\t\t<a class=\"ponca-hero__crumb\" href=\"https:\/\/qlogicllc.com\/poncatribe\/health-services\/\"\n\t\t\t\t\t\t   target=\"_self\"\t\t\t\t\t\t   \t\t\t\t\t\t   style=\"--hero-crumb-color:#A7A7A7;\">Health Services<\/a>\n\t\t\t\t\t\t\t\t\t\t\t<span class=\"ponca-hero__eyebrow-sep\" aria-hidden=\"true\" style=\"--hero-sep-color:#A7A7A7;\">\u2022<\/span>\n\t\t\t\t\t\t\t\t\t\t\t<span class=\"ponca-hero__crumb ponca-hero__crumb--plain\" style=\"--hero-crumb-color:#a78607;\">Health Forms<\/span>\n\t\t\t\t\t\t\t\t<\/nav>\n\t\t\n\t\t\t\t\t<h1 class=\"ponca-hero__title ponca-hero__title--inline\" style=\"--hero-title-font-family:&#039;Cormorant Garamond&#039;, Georgia, serif;--hero-title-font-size:clamp(3rem, 1.5rem + 4vw, 96px);--hero-title-line-height:clamp(60px, 7vw, 106px);--hero-title-letter-spacing:-0.02em;\">\n\t\t\t\t\t\t\t\t\t<span class=\"ponca-hero__title-line1\" style=\"--hero-title-line1-color:#FDFDFD;--hero-title-line1-font-style:normal;--hero-title-line1-font-weight:400;\">Health<\/span>\t\t\t\t\t\t\t\t\t<span class=\"ponca-hero__title-line2\" style=\"--hero-title-line2-color:#DEB209;--hero-title-line2-font-style:italic;--hero-title-line2-font-weight:400;\">Forms<\/span>\n\t\t\t\t\t\t\t<\/h1>\n\t\t\n\t\t\n\t\t\n\t<\/div>\n<\/section>\n\n\n<section style=\"--prcr-section-bg:#FFFDF6;--prcr-container-max-width:1504px;--prcr-container-gap:clamp(30px, 4vw, 60px);--prcr-header-gap:14px;--prcr-eyebrow-color:#DEB209;--prcr-eyebrow-font-family:&#039;DM Sans&#039;, &#039;Helvetica Neue&#039;, sans-serif;--prcr-eyebrow-font-size:13px;--prcr-eyebrow-line-height:22px;--prcr-eyebrow-font-weight:600;--prcr-eyebrow-font-style:normal;--prcr-eyebrow-letter-spacing:3px;--prcr-eyebrow-text-transform:uppercase;--prcr-title-font-family:&#039;Cormorant Garamond&#039;, &#039;Georgia&#039;, serif;--prcr-title-font-size:clamp(36px, 3.5vw, 56px);--prcr-title-line-height:clamp(42px, 4vw, 62px);--prcr-title-font-weight:300;--prcr-title-letter-spacing:-0.56px;--prcr-title-pre-color:#0D0F0E;--prcr-title-pre-font-style:normal;--prcr-title-accent-color:#B28E07;--prcr-title-accent-font-style:italic;--prcr-grid-columns:repeat(1, minmax(0, 1fr));--prcr-grid-column-gap:20px;--prcr-grid-row-gap:20px;--prcr-card-bg:#FFFFFF;--prcr-card-border-width:1px;--prcr-card-border-color:#F3F3F3;--prcr-card-radius:6px;--prcr-card-padding-y:24px;--prcr-card-padding-x:24px;--prcr-card-hover-bg:#FFFFFF;--prcr-card-hover-border:#F3F3F3;--prcr-card-left-gap:24px;--prcr-icon-wrap-size:50px;--prcr-icon-wrap-radius:100px;--prcr-icon-size:24px;--prcr-card-text-gap:6px;--prcr-card-title-color:#0D0F0E;--prcr-card-title-font-family:&#039;DM Sans&#039;, &#039;Helvetica Neue&#039;, sans-serif;--prcr-card-title-font-size:18px;--prcr-card-title-line-height:23px;--prcr-card-title-font-weight:500;--prcr-card-title-font-style:normal;--prcr-card-filetype-color:#848484;--prcr-card-filetype-font-family:&#039;DM Sans&#039;, &#039;Helvetica Neue&#039;, sans-serif;--prcr-card-filetype-font-size:14px;--prcr-card-filetype-line-height:18px;--prcr-card-filetype-font-weight:400;--prcr-card-filetype-font-style:normal;--prcr-btn-bg:transparent;--prcr-btn-color:#B28E07;--prcr-btn-border-width:1px;--prcr-btn-border-color:#B28E07;--prcr-btn-radius:100px;--prcr-btn-padding-y:6px;--prcr-btn-padding-x:16px;--prcr-btn-font-family:&#039;DM Sans&#039;, &#039;Helvetica Neue&#039;, sans-serif;--prcr-btn-font-size:12px;--prcr-btn-line-height:16px;--prcr-btn-font-weight:400;--prcr-btn-font-style:normal;--prcr-btn-letter-spacing:1px;--prcr-btn-text-transform:uppercase;--prcr-btn-gap:10px;--prcr-btn-hover-bg:#DEB209;--prcr-btn-hover-color:#0D0F0E;--prcr-btn-arrow-color:#B28E07;--prcr-btn-arrow-hover-color:#0D0F0E;--prcr-dl-bg:#B28E07;--prcr-dl-color:#FFFFFF;--prcr-dl-hover-bg:#8A6E04;--prcr-dl-hover-color:#FFFFFF;--prcr-dl-border-color:#B28E07;--prcr-dl-border-width:1px;--prcr-dl-radius:100px;--prcr-dl-py:10px;--prcr-dl-px:24px;--prcr-dl-font-family:&#039;DM Sans&#039;, &#039;Helvetica Neue&#039;, sans-serif;--prcr-dl-font-size:13px;--prcr-dl-font-weight:600;--prcr-dl-letter-spacing:1px;--prcr-dl-text-transform:uppercase;--prcr-icon-wrap-locked-bg:#F4F4F4;--prcr-icon-locked-color:#848484;--prcr-btn-locked-color:#848484;--prcr-btn-locked-border:#848484;--prcr-btn2-border-color:#B28E07;--prcr-btn2-bg:#DEB209;--prcr-btn2-color:#0d0f0e;--prcr-btn2-hover-bg:transparent;--prcr-btn2-hover-color:#B28E07;--prcr-btn2-icon-color:#0d0f0e;--prcr-btn2-hover-icon-color:#B28E07;--prcr-btn2-gap:12px;--prcr-ornament-height:clamp(56px, 5vw, 83px);--prcr-ornament-bg:transparent;--prcr-ornament-opacity:1;--prcr-ornament-image:url(&#039;https:\/\/qlogicllc.com\/poncatribe\/wp-content\/uploads\/2026\/05\/image-pattern.svg&#039;);--prcr-ornament-position:center bottom;--prcr-ornament-repeat:repeat;--prcr-ornament-size:auto 100%\" class=\"ponca-prcr sec_padding_footer wp-block-ponca-prc-resources\" aria-label=\"4 forms  available\">\n\t<div class=\"container ponca-prcr__container\">\n\n\t\t<header class=\"ponca-prcr__header\">\n\t\t\t<div class=\"ponca-prcr__header-text\">\n\t\t\t\t\t\t\t\t\t<span class=\"ponca-prcr__eyebrow\">Downloadable Forms<\/span>\n\t\t\t\t\t\t\t\t<h2 class=\"ponca-prcr__title\">\n\t\t\t\t\t<span class=\"ponca-prcr__title-pre\">4 forms <\/span> <span class=\"ponca-prcr__title-accent\">available<\/span>\t\t\t\t<\/h2>\n\t\t\t<\/div>\n\t\t\t\t\t<\/header>\n\n\t\t\t\t\t<div class=\"ponca-prcr__grid\">\n\t\t\t\t\t\t\t\t\t<div class=\"ponca-prcr__card\">\n\t\t\t\t\t\t<div class=\"ponca-prcr__card-left\">\n\t\t\t\t\t\t\t<span class=\"ponca-prcr__icon-wrap\">\n\t\t\t\t\t\t\t\t<svg class=\"ponca-prcr__pdf-svg\" width=\"24px\" height=\"24px\" viewBox=\"0 0 24 24\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" aria-hidden=\"true\" focusable=\"false\"><path d=\"M4.8 2 H17.4 L19.2 3.8 V22 H4.8 Z\" fill=\"#D92D20\"\/><path d=\"M17.4 2 V3.8 H19.2 Z\" fill=\"rgba(255,255,255,0.3)\"\/><rect x=\"6\" y=\"14\" width=\"12\" height=\"6\" rx=\"0.5\" fill=\"#D92D20\"\/><text x=\"12\" y=\"18.7\" font-family=\"Inter, Helvetica, Arial, sans-serif\" font-weight=\"700\" font-size=\"5\" fill=\"#FFFFFF\" text-anchor=\"middle\" letter-spacing=\"0\">PDF<\/text><\/svg>\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t<div class=\"ponca-prcr__card-text\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"ponca-prcr__card-title\">Patient Registration Intake Form and Authorization<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"ponca-prcr__card-filetype\">PDF<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"ponca-prcr__card-actions\">\n\n\t\t\t\t\t\t\t\t\t\t\t\t\t<a class=\"ponca-prcr__btn ponca-prcr__btn--alt\" href=\"https:\/\/qlogicllc.com\/poncatribe\/patient-registration-intake-form-and-authorization\/\" target=\"_blank\" rel=\"noopener noreferrer\" aria-label=\"Fill out form \u2014 Patient Registration Intake Form and Authorization\">\n\t\t\t\t\t\t\t\t<span class=\"ponca-prcr__btn-text\">Fill out form<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"ponca-prcr__btn-arrow\" aria-hidden=\"true\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" viewBox=\"0 0 30 30\" fill=\"none\" class=\"ponca-prcr__btn-arrow-img ponca-prcr__btn-arrow-img--svg\" width=\"20px\" height=\"20px\" style=\"width:20px;height:20px;\">\n  <path d=\"M25 10.3125V22.5C25 26.25 22.7625 27.5 20 27.5H10C7.2375 27.5 5 26.25 5 22.5V10.3125C5 6.25 7.2375 5.3125 10 5.3125C10 6.0875 10.3125 6.7875 10.825 7.3C11.3375 7.8125 12.0375 8.125 12.8125 8.125H17.1875C18.7375 8.125 20 6.8625 20 5.3125C22.7625 5.3125 25 6.25 25 10.3125Z\" stroke=\"currentColor\" stroke-width=\"1.5\" stroke-linecap=\"round\" stroke-linejoin=\"round\"><\/path>\n  <path d=\"M20 5.3125C20 6.8625 18.7375 8.125 17.1875 8.125H12.8125C12.0375 8.125 11.3375 7.8125 10.825 7.3C10.3125 6.7875 10 6.0875 10 5.3125C10 3.7625 11.2625 2.5 12.8125 2.5H17.1875C17.9625 2.5 18.6625 2.8125 19.175 3.325C19.6875 3.8375 20 4.5375 20 5.3125Z\" stroke=\"currentColor\" stroke-width=\"1.5\" stroke-linecap=\"round\" stroke-linejoin=\"round\"><\/path>\n  <path d=\"M10 16.25H15\" stroke=\"currentColor\" stroke-width=\"1.5\" stroke-linecap=\"round\" stroke-linejoin=\"round\"><\/path>\n  <path d=\"M10 21.25H20\" stroke=\"currentColor\" stroke-width=\"1.5\" stroke-linecap=\"round\" stroke-linejoin=\"round\"><\/path>\n<\/svg><\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t<a class=\"ponca-prcr__btn\" href=\"https:\/\/qlogicllc.com\/poncatribe\/wp-content\/uploads\/2026\/09\/Current-Ponca-Health-Services-Patient-Registration-Form-Fillable.pdf\" target=\"_blank\" rel=\"noopener noreferrer\" aria-label=\"Download \u2014 Patient Registration Intake Form and Authorization\">\n\t\t\t\t\t\t\t\t<span class=\"ponca-prcr__btn-text\">Download<\/span>\n\t\t\t\t\t\t\t\t<span class=\"ponca-prcr__btn-arrow\" aria-hidden=\"true\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" viewBox=\"0 0 16 16\" fill=\"none\" class=\"ponca-prcr__btn-arrow-img ponca-prcr__btn-arrow-img--svg\" width=\"20px\" height=\"20px\" style=\"width:20px;height:20px;\">\n  <path d=\"M7.99479 2V10.6667\" stroke=\"currentColor\" stroke-linecap=\"round\"><\/path>\n  <path d=\"M4.67188 8L8.00521 11.3333L11.3385 8\" stroke=\"currentColor\" stroke-linecap=\"round\"><\/path>\n  <path d=\"M13.3385 13.9987H2.67188\" stroke=\"currentColor\" stroke-linecap=\"round\"><\/path>\n<\/svg><\/span>\n\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<div class=\"ponca-prcr__card\">\n\t\t\t\t\t\t<div class=\"ponca-prcr__card-left\">\n\t\t\t\t\t\t\t<span class=\"ponca-prcr__icon-wrap\">\n\t\t\t\t\t\t\t\t<svg class=\"ponca-prcr__pdf-svg\" width=\"24px\" height=\"24px\" viewBox=\"0 0 24 24\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" aria-hidden=\"true\" focusable=\"false\"><path d=\"M4.8 2 H17.4 L19.2 3.8 V22 H4.8 Z\" fill=\"#D92D20\"\/><path d=\"M17.4 2 V3.8 H19.2 Z\" fill=\"rgba(255,255,255,0.3)\"\/><rect x=\"6\" y=\"14\" width=\"12\" height=\"6\" rx=\"0.5\" fill=\"#D92D20\"\/><text x=\"12\" y=\"18.7\" font-family=\"Inter, Helvetica, Arial, sans-serif\" font-weight=\"700\" font-size=\"5\" fill=\"#FFFFFF\" text-anchor=\"middle\" letter-spacing=\"0\">PDF<\/text><\/svg>\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t<div class=\"ponca-prcr__card-text\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"ponca-prcr__card-title\">Patient Health Summary \u2014 Adult<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"ponca-prcr__card-filetype\">PDF<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"ponca-prcr__card-actions\">\n\n\t\t\t\t\t\t\t\t\t\t\t\t\t<a class=\"ponca-prcr__btn ponca-prcr__btn--alt\" href=\"https:\/\/qlogicllc.com\/poncatribe\/patient-health-summary-adult\/\" target=\"_blank\" rel=\"noopener noreferrer\" aria-label=\"fill out form \u2014 Patient Health Summary \u2014 Adult\">\n\t\t\t\t\t\t\t\t<span class=\"ponca-prcr__btn-text\">fill out form<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"ponca-prcr__btn-arrow\" aria-hidden=\"true\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" viewBox=\"0 0 30 30\" fill=\"none\" class=\"ponca-prcr__btn-arrow-img ponca-prcr__btn-arrow-img--svg\" width=\"20px\" height=\"20px\" style=\"width:20px;height:20px;\">\n  <path d=\"M25 10.3125V22.5C25 26.25 22.7625 27.5 20 27.5H10C7.2375 27.5 5 26.25 5 22.5V10.3125C5 6.25 7.2375 5.3125 10 5.3125C10 6.0875 10.3125 6.7875 10.825 7.3C11.3375 7.8125 12.0375 8.125 12.8125 8.125H17.1875C18.7375 8.125 20 6.8625 20 5.3125C22.7625 5.3125 25 6.25 25 10.3125Z\" stroke=\"currentColor\" stroke-width=\"1.5\" stroke-linecap=\"round\" stroke-linejoin=\"round\"><\/path>\n  <path d=\"M20 5.3125C20 6.8625 18.7375 8.125 17.1875 8.125H12.8125C12.0375 8.125 11.3375 7.8125 10.825 7.3C10.3125 6.7875 10 6.0875 10 5.3125C10 3.7625 11.2625 2.5 12.8125 2.5H17.1875C17.9625 2.5 18.6625 2.8125 19.175 3.325C19.6875 3.8375 20 4.5375 20 5.3125Z\" stroke=\"currentColor\" stroke-width=\"1.5\" stroke-linecap=\"round\" stroke-linejoin=\"round\"><\/path>\n  <path d=\"M10 16.25H15\" stroke=\"currentColor\" stroke-width=\"1.5\" stroke-linecap=\"round\" stroke-linejoin=\"round\"><\/path>\n  <path d=\"M10 21.25H20\" stroke=\"currentColor\" stroke-width=\"1.5\" stroke-linecap=\"round\" stroke-linejoin=\"round\"><\/path>\n<\/svg><\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t<a class=\"ponca-prcr__btn\" href=\"https:\/\/qlogicllc.com\/poncatribe\/wp-content\/uploads\/2026\/06\/patient_reg_health_summary_adult.pdf\" target=\"_blank\" rel=\"noopener noreferrer\" aria-label=\"Download \u2014 Patient Health Summary \u2014 Adult\">\n\t\t\t\t\t\t\t\t<span class=\"ponca-prcr__btn-text\">Download<\/span>\n\t\t\t\t\t\t\t\t<span class=\"ponca-prcr__btn-arrow\" aria-hidden=\"true\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" viewBox=\"0 0 16 16\" fill=\"none\" class=\"ponca-prcr__btn-arrow-img ponca-prcr__btn-arrow-img--svg\" width=\"20px\" height=\"20px\" style=\"width:20px;height:20px;\">\n  <path d=\"M7.99479 2V10.6667\" stroke=\"currentColor\" stroke-linecap=\"round\"><\/path>\n  <path d=\"M4.67188 8L8.00521 11.3333L11.3385 8\" stroke=\"currentColor\" stroke-linecap=\"round\"><\/path>\n  <path d=\"M13.3385 13.9987H2.67188\" stroke=\"currentColor\" stroke-linecap=\"round\"><\/path>\n<\/svg><\/span>\n\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<div class=\"ponca-prcr__card\">\n\t\t\t\t\t\t<div class=\"ponca-prcr__card-left\">\n\t\t\t\t\t\t\t<span class=\"ponca-prcr__icon-wrap\">\n\t\t\t\t\t\t\t\t<svg class=\"ponca-prcr__pdf-svg\" width=\"24px\" height=\"24px\" viewBox=\"0 0 24 24\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" aria-hidden=\"true\" focusable=\"false\"><path d=\"M4.8 2 H17.4 L19.2 3.8 V22 H4.8 Z\" fill=\"#D92D20\"\/><path d=\"M17.4 2 V3.8 H19.2 Z\" fill=\"rgba(255,255,255,0.3)\"\/><rect x=\"6\" y=\"14\" width=\"12\" height=\"6\" rx=\"0.5\" fill=\"#D92D20\"\/><text x=\"12\" y=\"18.7\" font-family=\"Inter, Helvetica, Arial, sans-serif\" font-weight=\"700\" font-size=\"5\" fill=\"#FFFFFF\" text-anchor=\"middle\" letter-spacing=\"0\">PDF<\/text><\/svg>\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t<div class=\"ponca-prcr__card-text\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"ponca-prcr__card-title\">Patient Health Summary \u2014 Child<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"ponca-prcr__card-filetype\">PDF<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"ponca-prcr__card-actions\">\n\n\t\t\t\t\t\t\t\t\t\t\t\t\t<a class=\"ponca-prcr__btn ponca-prcr__btn--alt\" href=\"https:\/\/qlogicllc.com\/poncatribe\/patient-health-summary-child\/\" target=\"_blank\" rel=\"noopener noreferrer\" aria-label=\"fill out form \u2014 Patient Health Summary \u2014 Child\">\n\t\t\t\t\t\t\t\t<span class=\"ponca-prcr__btn-text\">fill out form<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"ponca-prcr__btn-arrow\" aria-hidden=\"true\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" viewBox=\"0 0 30 30\" fill=\"none\" class=\"ponca-prcr__btn-arrow-img ponca-prcr__btn-arrow-img--svg\" width=\"20px\" height=\"20px\" style=\"width:20px;height:20px;\">\n  <path d=\"M25 10.3125V22.5C25 26.25 22.7625 27.5 20 27.5H10C7.2375 27.5 5 26.25 5 22.5V10.3125C5 6.25 7.2375 5.3125 10 5.3125C10 6.0875 10.3125 6.7875 10.825 7.3C11.3375 7.8125 12.0375 8.125 12.8125 8.125H17.1875C18.7375 8.125 20 6.8625 20 5.3125C22.7625 5.3125 25 6.25 25 10.3125Z\" stroke=\"currentColor\" stroke-width=\"1.5\" stroke-linecap=\"round\" stroke-linejoin=\"round\"><\/path>\n  <path d=\"M20 5.3125C20 6.8625 18.7375 8.125 17.1875 8.125H12.8125C12.0375 8.125 11.3375 7.8125 10.825 7.3C10.3125 6.7875 10 6.0875 10 5.3125C10 3.7625 11.2625 2.5 12.8125 2.5H17.1875C17.9625 2.5 18.6625 2.8125 19.175 3.325C19.6875 3.8375 20 4.5375 20 5.3125Z\" stroke=\"currentColor\" stroke-width=\"1.5\" stroke-linecap=\"round\" stroke-linejoin=\"round\"><\/path>\n  <path d=\"M10 16.25H15\" stroke=\"currentColor\" stroke-width=\"1.5\" stroke-linecap=\"round\" stroke-linejoin=\"round\"><\/path>\n  <path d=\"M10 21.25H20\" stroke=\"currentColor\" stroke-width=\"1.5\" stroke-linecap=\"round\" stroke-linejoin=\"round\"><\/path>\n<\/svg><\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t<a class=\"ponca-prcr__btn\" href=\"https:\/\/qlogicllc.com\/poncatribe\/wp-content\/uploads\/2026\/06\/patient_reg_health_summary_child.pdf\" target=\"_blank\" rel=\"noopener noreferrer\" aria-label=\"Download \u2014 Patient Health Summary \u2014 Child\">\n\t\t\t\t\t\t\t\t<span class=\"ponca-prcr__btn-text\">Download<\/span>\n\t\t\t\t\t\t\t\t<span class=\"ponca-prcr__btn-arrow\" aria-hidden=\"true\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" viewBox=\"0 0 16 16\" fill=\"none\" class=\"ponca-prcr__btn-arrow-img ponca-prcr__btn-arrow-img--svg\" width=\"20px\" height=\"20px\" style=\"width:20px;height:20px;\">\n  <path d=\"M7.99479 2V10.6667\" stroke=\"currentColor\" stroke-linecap=\"round\"><\/path>\n  <path d=\"M4.67188 8L8.00521 11.3333L11.3385 8\" stroke=\"currentColor\" stroke-linecap=\"round\"><\/path>\n  <path d=\"M13.3385 13.9987H2.67188\" stroke=\"currentColor\" stroke-linecap=\"round\"><\/path>\n<\/svg><\/span>\n\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<div class=\"ponca-prcr__card\">\n\t\t\t\t\t\t<div class=\"ponca-prcr__card-left\">\n\t\t\t\t\t\t\t<span class=\"ponca-prcr__icon-wrap\">\n\t\t\t\t\t\t\t\t<svg class=\"ponca-prcr__pdf-svg\" width=\"24px\" height=\"24px\" viewBox=\"0 0 24 24\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" aria-hidden=\"true\" focusable=\"false\"><path d=\"M4.8 2 H17.4 L19.2 3.8 V22 H4.8 Z\" fill=\"#D92D20\"\/><path d=\"M17.4 2 V3.8 H19.2 Z\" fill=\"rgba(255,255,255,0.3)\"\/><rect x=\"6\" y=\"14\" width=\"12\" height=\"6\" rx=\"0.5\" fill=\"#D92D20\"\/><text x=\"12\" y=\"18.7\" font-family=\"Inter, Helvetica, Arial, sans-serif\" font-weight=\"700\" font-size=\"5\" fill=\"#FFFFFF\" text-anchor=\"middle\" letter-spacing=\"0\">PDF<\/text><\/svg>\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t<div class=\"ponca-prcr__card-text\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"ponca-prcr__card-title\">Diabetes Education Assessment<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"ponca-prcr__card-filetype\">PDF<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"ponca-prcr__card-actions\">\n\n\t\t\t\t\t\t\t\t\t\t\t\t\t<a class=\"ponca-prcr__btn ponca-prcr__btn--alt\" href=\"https:\/\/qlogicllc.com\/poncatribe\/diabetes-education-assessment\/\" target=\"_blank\" rel=\"noopener noreferrer\" aria-label=\"fill out form \u2014 Diabetes Education Assessment\">\n\t\t\t\t\t\t\t\t<span class=\"ponca-prcr__btn-text\">fill out form<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"ponca-prcr__btn-arrow\" aria-hidden=\"true\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" viewBox=\"0 0 30 30\" fill=\"none\" class=\"ponca-prcr__btn-arrow-img ponca-prcr__btn-arrow-img--svg\" width=\"20px\" height=\"20px\" style=\"width:20px;height:20px;\">\n  <path d=\"M25 10.3125V22.5C25 26.25 22.7625 27.5 20 27.5H10C7.2375 27.5 5 26.25 5 22.5V10.3125C5 6.25 7.2375 5.3125 10 5.3125C10 6.0875 10.3125 6.7875 10.825 7.3C11.3375 7.8125 12.0375 8.125 12.8125 8.125H17.1875C18.7375 8.125 20 6.8625 20 5.3125C22.7625 5.3125 25 6.25 25 10.3125Z\" stroke=\"currentColor\" stroke-width=\"1.5\" stroke-linecap=\"round\" stroke-linejoin=\"round\"><\/path>\n  <path d=\"M20 5.3125C20 6.8625 18.7375 8.125 17.1875 8.125H12.8125C12.0375 8.125 11.3375 7.8125 10.825 7.3C10.3125 6.7875 10 6.0875 10 5.3125C10 3.7625 11.2625 2.5 12.8125 2.5H17.1875C17.9625 2.5 18.6625 2.8125 19.175 3.325C19.6875 3.8375 20 4.5375 20 5.3125Z\" stroke=\"currentColor\" stroke-width=\"1.5\" stroke-linecap=\"round\" stroke-linejoin=\"round\"><\/path>\n  <path d=\"M10 16.25H15\" stroke=\"currentColor\" stroke-width=\"1.5\" stroke-linecap=\"round\" stroke-linejoin=\"round\"><\/path>\n  <path d=\"M10 21.25H20\" stroke=\"currentColor\" stroke-width=\"1.5\" stroke-linecap=\"round\" stroke-linejoin=\"round\"><\/path>\n<\/svg><\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t<a class=\"ponca-prcr__btn\" href=\"https:\/\/qlogicllc.com\/poncatribe\/wp-content\/uploads\/2026\/06\/diabetes_educational_assessment.pdf\" target=\"_blank\" rel=\"noopener noreferrer\" aria-label=\"Download \u2014 Diabetes Education Assessment\">\n\t\t\t\t\t\t\t\t<span class=\"ponca-prcr__btn-text\">Download<\/span>\n\t\t\t\t\t\t\t\t<span class=\"ponca-prcr__btn-arrow\" aria-hidden=\"true\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" viewBox=\"0 0 16 16\" fill=\"none\" class=\"ponca-prcr__btn-arrow-img ponca-prcr__btn-arrow-img--svg\" width=\"20px\" height=\"20px\" style=\"width:20px;height:20px;\">\n  <path d=\"M7.99479 2V10.6667\" stroke=\"currentColor\" stroke-linecap=\"round\"><\/path>\n  <path d=\"M4.67188 8L8.00521 11.3333L11.3385 8\" stroke=\"currentColor\" stroke-linecap=\"round\"><\/path>\n  <path d=\"M13.3385 13.9987H2.67188\" stroke=\"currentColor\" stroke-linecap=\"round\"><\/path>\n<\/svg><\/span>\n\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t\n\t\t\n\t<\/div>\n\n\t\t\t<div class=\"ponca-prcr__ornament ponca-prcr__ornament--image\" aria-hidden=\"true\">\n\t\t\t\t\t<\/div>\n\t<\/section>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":80,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"inline_featured_image":false,"_mytheme_footer_image_id":0,"footnotes":""},"class_list":["post-1155","page","type-page","status-publish","hentry"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.4 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Health Forms - Ponca Tribe<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/qlogicllc.com\/poncatribe\/health-forms\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Health Forms - Ponca Tribe\" \/>\n<meta property=\"og:url\" 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