Receive Our Health e-Newsletter Patient Portal Access

Patient Information
BE AN ACTIVE PARTICIPANT

While the success of the Patient Centered Medical Home model depends on the attention and skill of our medical team, your input and involvement are also very important.  By providing your health care team with the information they need, and following your personal health plan, you will reach your health care goals and ensure a happy, healthy future.  

Please provide our contact information to any facility or clinician (self-referrals)  that you obtain care from outside of your medical home to ensure we have the most up-to-date information.

HELP US, HELP YOU
  • Please provide us with a complete medical history on you and your family
  • Inform us of any hospital stays, medications and other health-related matters where you obtained care outside of your medical home
  • Work together to build a care plan
  • Let us know if you are unable to take your medicine or follow through with your care plan
  • Tell us about your needs and concerns
  • Ask for help if you don't fully understand something
  • Prepare an Advance Directive and be certain we have it on file
  • Understand that your lifestyle choices affect your personal health
  • Give us feed back so we can improve our services
  • Contact us for all your health needs


NEW PATIENTS (INITIAL VISIT):

Please complete the following forms before your appointment
  • PHQ-9
  • Depression Questionaire
  • Release of Information (you may call the office for assistance with this)
  • Privacy Policy
  • Consent for Treatment

ALL PATIENTS MUST COMPLETE ONCE :
  • Health Care Proxy

YEARLY EXAMS AND NEW PATIENTS (DONE YEARLY):
  • PHQ9 (Depression Screening)
Patient Satisfaction Survey
PHQ-9
DNR
Depression Questionaire
Consent for Treatment
Nondiscrimination and Accessibility Statement
Privacy Policy
hippa release
health care proxy

Copyright HealthBanks, Inc. All rights reserved. | Terms of Use | Privacy Policy