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Standard forms

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Welcome Packet Registration
- Print and fill out -

Please read and complete your Welcome Packet before your first appointment!

Includes:

  • What to bring to your first appointment

  • Patient Registration

  • Contact information

  • Patient-Centered Medical Home information

  • Consent to Care Management

  • Consent to Virtual Appointments

  • Notice of Privacy Practices

  • Authorization for Release of Medical Information   

Personal Contacts

We request that you renew this information every year.  This helps preserve your privacy, and allows us to share your personal health information with those you want to have involved in your health care.

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