Patient Forms
The following documents and forms can be downloaded to your computer
and printed out. By completing the forms ahead of time, you can save a
significant amount of time during your visit. Please bring the filled in and
signed forms, along with your current insurance card,to the physician's
office at the time of your initial visit.
and printed out. By completing the forms ahead of time, you can save a
significant amount of time during your visit. Please bring the filled in and
signed forms, along with your current insurance card,to the physician's
office at the time of your initial visit.
• Adult Patient Registration Form
• Child/Dependent Registration Form
• Patient Portal Sign Up Form
• Newborn Insurance Reminder
• Patien5/HIPAA Acknowledgement Form
• Notice of Privacy Practices
• Practice Philosophy
• Payment Policy
• Signature On File Form
• Authorization to Bring Minor
• Request to Copy
Protected Health Information
• Portal Proxy Consent
• Self Pay Acknowledgement
To help you better understand
your Primary Care Partners, LLC
statement, please download the
PCP Billing Statement Guide.
• PCP Billing Statement Guide
your Primary Care Partners, LLC
statement, please download the
PCP Billing Statement Guide.
• PCP Billing Statement Guide