Patient Forms - Authentic Health

PATIENT FORMS

Patient Information Forms

If you are a first-time visitor to our practice OR updating information for your annual physical, please PRINT and fill out this form.

Medical Records Release Form

If you need to transfer your medical records from another doctor’s office, please PRINT and fill out this form.

HIPAA Notice

Review our Notice of Privacy Practices (HIPAA information) and attestation.

Medicare Wellness Checkup

Complete checklist before seeing your doctor or nurse; please PRINT and fill out this form.

No Show Policy

Please take a moment to read our updated No-Show Policy for patients. This form was last updated in June 2022.

Privacy Policy Directive

If you are a first-time visitor to our practice OR updating information for your annual physical, please PRINT and fill out this form.