Online Demographics Form

New Patient Registration Form

These forms are to be completed prior to your first appointment at our office. Please remember to bring them with you, along with your insurance card. You should print off a Transfer of Records form to obtain any old records from your previous doctor before your visit and a Health History Form so the doctor has record of your past problems and conditions. If you filled out the online demographics form, you will not need to complete Page 1 of this download.

Transfer of Medical Records Form

This form will request your former physician or health practice to transfer records to Family Care, PA for continuing care, or consultation.

Health History Form

This form is to update your health history and symptoms you have had in the past year. Please complete this form prior to your annual physical examination.

Pre-Paid Plan Brochure

This is a plan we offer to patients without insurance or with an out of network insurance to help plan their medical expenses for the year and receive a discounted rate by signing up for a package deal.