Forms

All Premier patients complete the following forms:

  • Patient registration – personal details, including insurance coverage
  • Patient medical history – your current health status and family medical history
  • Patient rights & responsibilities – details your rights to your health information and patient financial responsibility
  • Patient privacy practices
  • Medical Release
  • Permission – list of other people you designate to have access to your health information

You may print the following PDFs and complete them in advance of your appointment.

Patient History Form
Patient Registration
Patient Rights and Responsibilities
Authorization for Disclosure of Health Information