New Patient Paperwork

Please email completed forms to newpatient@fhcsandpoint.com (Please note this is not an encrypted email) 

Adult New Patient Paperwork (pdf)

Download

Adult New Patient Paperwork -FILL FORM (docx)

Download

Pediatric new patient paperwork (docx)

Download

Wellness Forms

Medicare Wellness form (65 years old +) (pdf)

Download

Female Wellness Form (under 65 yrs old) (pdf)

Download

Male Wellness (under 65 years old) (pdf)

Download

Teen wellness form (13-18 years old) (docx)

Download

Medical Records Release Forms

Records to be sent to us from another facility or office (doc)

Download

Records to be sent from us to another facility or office (doc)

Download

Form to release records to another person or give them access to your health information (doc)

Download

Sports Physical Form (pdf)

Download

Disability Parking Application (pdf)

Download

DOT Forms

Dr. Waters - DOT Form (pdf)

Download

Dr. Dunn - DOT Form (pdf)

Download

End of Life Forms

PACKET -End of life forms with FAQ (pdf)

Download

LIVING WILL (docx)

Download

DURABLE POWER OF ATTORNEY FOR HEALTH CARE (docx)

Download

Please email signed consent to us @ fhcinfo@fhcsandpoint.com

Video Visit Consent Form (pdf)

Download

Video Visit Consent Form - Medicare Pts (pdf)

Download