Draves Family Medicine  
Patient Forms
and Privacy Practices
   
 
Forms and Privacy

If you are an ADULT over the age of 18 you may print and complete the forms at home and bring them in at the time of your appointment

Adult Patient Information Record
Adult Health History
Attendance Policy
Financial Policy
Draves Family Medicine HIPPA Consent
Authorizations Form

READ the HIPAA Notice of Privacy Practice
and then SIGN the Notice of Privacy Practices Acknowledgement

_____________________________________________

If the patient is your child under the age of 18 you may print and complete the forms at home and bring them in at the time of your appointment

Child Patient Information Record
Attendance Policy
Financial Policy
Draves Family Medicine HIPPA Consent

READ the HIPAA Notice of Privacy Practice
and then SIGN the Notice of Privacy Practices Acknowledgement