In an effort to provide you with as much information as possible and to ensure the minimal wait time for our patients who wish to see one of our general medical doctors, we have provided many of the medical forms we use in our health care clinic. We recommend you download and fill-in the necessary forms prior to your office visit. This will allow you to provide accurate information and speed up the treatment process.

Notice of Privacy Policy

Please print and read this form so you are aware of our privacy policies. You do not have to bring in the form to your office visit. It is strictly to describe how medical information about you may be used and disclosed, and how you can get access to this information.

Notice of Privacy Practices (NPP) Policy and Financial Policy

Please print and read this form. You will need to answer question #10, enter the Date and your Signature, and then bring it with you to your first office visit.

Authorization for Release of Confidential Medical Records

This form allows you to request your medical records from another general medical doctor so that they can be sent to our offices in preparation for your visit. This will help our Doctors have all the pertinent records of your medical history. Please print this form and take it to your other Doctor or Specialist prior to your office visit.

Medicare Private Health Contract

If you are a Medicare Patient, you will need to fill out this form. Our medical office does not participate in Medicare.  If you wish to have our office provide care for you, please print and read this policy so that you are aware of the terms of your visit. Please "DO NOT" sign it, simply read it and bring it in to your office visit. A "witness" must see you sign the form and then also sign as well.

The above medical forms are downloadable in PDF files. You will need Adobe Acrobat reader in order to view them. If you do not have this program, click here to get a free copy of the software.