To ensure that we have all of your current demographic and health information, we have included the following forms for you to complete. To view the form, please click on the form name:
New Patient Forms
New Patient Packet
Family Health History
*external site hosted by The Department of Health and Human Services
Release Of Information Forms
Authorize Clay Platte Family Medicine Clinic to furnish records to another provider
Authorize Clay Platte Family Medicine Clinic to receive records from another provider
Physical Forms
Female Physical Forms
Male Physical Forms
Diabetes Management Forms
Goals For Patients with Diabetes
Weekly Blood Sugar Log
Weekly Food Intake Record
Basics of Meal Planning
Food Category Information
Cholesterol Information
Daily Caloric Needs
My Activity Diary
Advanced Directives
Center for Practical Bioethics
We appreciate that time that you take to compete these documents in advance. By decreasing the amount of paperwork that you need to fill out when you arrive at our office, we are able to start your visit with your provider sooner.
. |
