New Patient Paperwork

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

Adult New Patient Paperwork (pdf)

Adult New Patient Paperwork -FILL FORM (docx)

Pediatric new patient paperwork (docx)

Wellness Forms

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

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

Male Wellness (under 65 years old) (pdf)

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

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

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

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

Sports Physical Form (pdf)

Disability Parking Application (pdf)

Dr. Waters - DOT Form (pdf)

Dr. Dunn - DOT Form (pdf)

PACKET -End of life forms with FAQ (pdf)

LIVING WILL (docx)

DURABLE POWER OF ATTORNEY FOR HEALTH CARE (docx)

Video Visit Consent Form (pdf)

Video Visit Consent Form - Medicare Pts (pdf)