Medical Direct Care Forms
NEW PT REGISTRATION PCKTS – vs 3 – 5.21.18
10-13-2016-v2-authorization-for-release-of-medical-records
10-13-2016-v4-notice-of-privacy-practices
10-13-2016-vs-3new-patient-registration-form
10-13-2016-whole-page-large-print-my-agenda
2016_10_13-proof-of-immunization-disclosure
2016_10_13_authorization-of-release-of-medical-records
2016_10_13_consent-for-use-disclosure-of-health-information
2016_10_13_medical-direct-care-no-show-policy
02012015-revoke-rights-to-records
dismissal-letter-breakdown-of-the-physician-patient-relationship
dismissal-letter-failure-to-cooperate-in-medical-care-treatment
dismissal-letter-failure-to-mutually-payable-plan-outstanding-medical-bill