Preferred Medical Group, PC

"Compassionate Care for All Ages"

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Document
Welcome-New Patient Registration forms 2010 mw
Document
Patient Privacy HIPAA form

New patients should download and complete these forms:

1. New patient registration

2. HIPAA privacy form

3. Credit Card Form

4. New patient history form

Please bring these to your office visit. Complete as best you can, don't worry about anything not understood or informaiton you do not have easily available. We look forward to seeing you soon.


The remaining forms pertain to Complete Physical Examinations or general information. Prior to your Complete Physical Examination, please download and complete these forms:

1. Physical pre-exam form.

2. Physical consent form

Thank you
   

Marc F. Weisman, D.O., F.A.A.F.P. / Jason Talbert, M.D. / Alan Carbajo, M.D. /Tara Caudill-Deaton, M.D. / Dwijen Misra, M.D. / Michelle Petropoulos, M.S., P.A.-C / Heidie Vasko, P.A.-C

248.543.0600 (phone) 248.543.4720(fax)

www.preferredDOCS.com

Preferred Medical Group, PC. All rights reserved. Copyright 2006