The Family Physicians
Compassionate Health Care at
Every Stage of Life
Notice of Privacy Practices
This notice describes how we use and protect your personal health information.
Consent to Treat Minor
This form gives a provider permission to treat your child when he or she is in someone else's care.
Medical Records Release
Authorize the release of full and complete protected medical information to a requiring entity
Policy and Procedures on use of the patient portal.
Patient Portal Consent Form
OB Financial Agreement
This form is the OB Financial Agreement Explanation Sheet
Vehicle Accident Report Form
Fill this form out before your appointment to cover the details of your accident.
Sports Physical Form
Fill this form out before your physical examination.
We are dedicated to providing you the most current and up-to-date information regarding your privacy and changes in our practice. Please use these forms to update us when any of your demographic information changes. This will help keep the information in your chart current.