Family Health Center : Pre-Registration : Release of Information Form, Patient Demographic

Please take some time to fill out the following forms prior to your office visit if you have not been seen at the Family Health Center before. Having these forms filled out prior to your visit will greatly decrease your wait time.

Please print and fill out the following forms prior to your office visit:

New Patient Information - Patient information form including your name, contact information and insurance information.
Medical Information Release - Authorization for release of medical information.