If you're a new patient, please complete the following forms and bring them to your first appointment.

Before Your Appointment

Preparing for your appointment

Before arriving for your appointment, please make sure you have the following items with you:

  • A photo ID, such as your license

  • Your most recent insurance card

  • List of all current medications – including prescribed medications and over the counter medications.

  • The phone number to the Pharmacy where your prescriptions are filled. (Walgreens, CVS, Walmart etc.)

  • Make a list before your visit of any questions or topics you may wish to discuss with your physician.

  • It is very important that you bring copies of medical information from your other doctors. Please make arrangements with your other doctor(s) to obtain copies of those charts, test results (labs) and imaging results (CT, MRI, Ultrasound, Mammography etc.) that you may have had done.

Click the link below to download Adobe PDF Reader  
Please print out the forms below and fill out to bring in to your first appointment. Thank you and we are looking forward to seeing you soon.
For Life-Threatening Emergencies Call 911

© 2017 by Advanced Internal Medicine Care