Woodlands Functional Family Medicine Forms

Click the caption to save each form to your computer. Then print, fill in, and bring with you to your appointment.

Patient Information WFFM_Page_1

New Patient Information

New Patient History

New Patient History and Physical Questionnaire

Medication History

Medication History

Release of Protected Healthcare Information

Release of Protected Health Information

Parental Preauthorization

Parental Preauthorization for Medical Care to Children

HIPAA privacy policy

Health Insurance Portability and Accountability Act (HIPAA) Acknowledgement of Review of Notice of Privacy Practices

HIPAA consent

Health Insurance Portability and Accountability Act (HIPAA) Consent Form

Authorization and Assignments

Authorization and Assignments

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