PATIENT HEALTH INFORMATION arrows


MONTHLY FEATURE

Pacific Medical Group's Online Services now available!


Click on the Online Services tab to request a PIN or to log in to your Online Services account. 


In an effort to expedite the registration process at your first visit, please click on each of the forms below.  Some only require you to print and sign and others, such as the Patient Registration form, require you to type in your information and print.

 

Please complete and print these forms to bring to your first visit:



General Documents
Credit and Payment Policy [pdf]
Genetic Privacy Notice [pdf]

HIPAA Consent [pdf]
Medical History [pdf]
Patient Registration [doc]
Fillable Authorization to Release Medical Records [doc]

Non-Fillable Authorization to Release Medical Records [pdf]

HIPAA Notice of Privacy Practices [doc]
Physical Therapy
PT Credit and Payment Policy [pdf]
PT Cancellation Policy [pdf]
PT Medical History & Consent for Care [doc]
PT Pain Diagram [pdf]
PT HIPAA Consent [pdf]
PT HIPAA Notice of Privacy Practices[doc]