Patient Downloads

Click on the links below to download the indicated file. New patients will need to complete a demographics form (either the online version or the paper version) and Health History Form.

New Patient Registration Form
[ddownload id=”9931″]

These forms are to be completed prior to your first appointment at our office. Please remember to bring them with you, along with your insurance card. You should print off a Transfer of Records form to obtain any old records from your previous doctor before your visit and complete the Health History Form included in the packet so the doctor has record of your past problems and conditions. If you filled out the online demographics form, you will not need to complete Page 1 of this download.

Health History Form
[ddownload id=”9935″]

This form is to update your health history and symptoms you have had in the past year. Please complete this form prior to your annual physical examination.

Request for Medical Records Form
[ddownload id=”343″]

This form will request your former physician or health practice to transfer records to Family Care, PA for continuing care, or consultation. This requests records to be sent to Family Care.

Transfer of Medical Records Form
[ddownload id=”342″]

This form will be required for Family Care, PA to transfer records to another facility or physician. This requests records to be sent from Family Care to another facility.