Thank you for choosing Regional Family Medicine for your health care needs.  Before your first appointment, please print the following forms and fill in the appropriate information.  Be sure all forms are signed and dated where noted, and bring the forms, your insurance card(s), and a photo ID to your upcoming appointment. 

PLEASE NOTE:  THESE FORMS WILL NOT TRANSFER TO US AUTOMATICALLY YOU WILL NEED TO PRINT AND FAX OR BRING BY ONE OF OUR LOCATIONS.

• New Patient Questionnaire
• HIPPA Privacy Policy
• New Patient Questionnaire
• New Patient Packet Complete

• New Patient Information
• Medical Records Release Form
• New Patient Medical History Form 
• New Patient HIPPA Release Form
• HIPPA Patient Contact and Email Form 
• New Patient Welcome Letter