Patient Forms

NEW PATIENTS

Click HERE to download our new patient packet in English. It contains forms you will need to print out, complete, and bring with you to your first visit.

Click HERE to download our new patient packet in Spanish. It contains forms you will need to print out, complete, and bring with you to your first visit.

Click HERE to read our privacy policy, patient bill of rights, and patient centered medical home brochure in English.

Click HERE to read our privacy policy, patient bill of rights, and patient centered medical home brochure in Spanish.


MEDICAL RECORDS RELEASE FORMS

1.) Click HERE to download our medical records release forms in English. Use page 1 to have your records SENT to another facility; use page 2 to request that MAHEC RECEIVE your records from another office.

2.) Click HERE to download our medical records release forms in Spanish. Use page 1 to have your records SENT to another facility; use page 2 to request that MAHEC RECEIVE your records from another office.

Note that a fee will be charged if you are requesting the records for yourself. There is no charge for sending records to another facility.


MEND TELEMEDICINE CONSENT FORMS

You will sign these forms electronically at the beginning of your telemedicine visit. If you would like a copy for your records, please click HERE.