Forms

New Patients:

• Don't forget to bring your photo ID and your insurance card!
• Please fill out and/or sign the following three documents and bring to your appointment:

           - New Patient Medical History Form

            -  Demographics Form

               - HIPAA Notice of Privacy Practices

Other Patient Forms:

• If you are coming in for your annual exam and you have already seen us, please fill out the EXISTING PATIENT MEDICAL HISTORY FORM                                
• If you would like to authorize us to discuss confidential medical information with a family member, please fill out and sign the AUTHORIZATION TO DISCUSS MEDICAL INFORMATION
• If you would like to authorize us to send your records to you or your primary care provider, you must fill out and sign the 
  RELEASE OF RECORDS FORM
  

After printing the above forms from your printer, simply complete and bring with you to your appointment.  If you have any questions, please contact us at the Oxford office (248) 236-0840.