Thank you for choosing Neighborhood Primary Care for your healthcare needs! Before you come into the office, we want you to be fully prepared! Please arrive 15 minutes early and have your forms completed prior to your appointment time, this helps us give you better service and reduce office wait times. If you have any questions, please call the office.
- Valid Driver’s License
- Valid Insurance Card
- Preferred Pharmacy information
The following are a list of required forms for New Patients that need to be completed prior to your visit. Please print and fill out each of these forms. If you have trouble completing these forms or if you have any questions, please call the office and we would be happy to assist you.
- Patient Intake Form
- Patient Demographics
- Consent Form
- Financial Responsibility
- Acknowledgement of Privacy Practice
- Release of Protected Health Information ("PHI")
- Medical Records Release
- Fill out this form if you would like us to receive medical records from your other providers.
- Examples include; Cardiologist, Primary Care, Pediatrician, Urologist, Orthopedic, Rheumatologist, etc.…