Preferred Medical Group, PC

"Compassionate Care for All Ages"

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Your Previous Medical Records
Obtaining your prior health care records is an important aspect of your first visits to our office. Typically, we prefer to receive a copy of pertinent records. All you need to do is download this form and sign as many as there are different doctor's or hospital's that have the records you consider important. If possible, please include the fax number or address of these doctor's / hospital's. We will fax or mail these requests for you at your office visit.
Document
Prior Medical Records Form

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