Get New Patient Forms - Fampracticeassociates.com

Filling out the new patient forms is a vital step in receiving quality healthcare at Family Practice Associates. This guide will assist you in completing the online form accurately and efficiently, ensuring that you provide all necessary information to facilitate your visit.

Follow the steps to successfully complete your new patient forms online.

1. Press the ‘Get Form’ button to access the new patient forms. This will open the document in your browser or preferred editing tool.
2. Begin by entering your personal information, including your full name, date of birth, social security number, age, sex, and contact details such as your home, work, and cell phone numbers. Be sure to include your complete address and zip code.
3. Next, you will need to provide details about your occupation and the name and address of your employer. If applicable, enter the name of your spouse, along with their employer information.
4. If someone else is responsible for the bill, fill in their details in the designated fields, ensuring that you include their relationship to you, contact information, and employment details.
5. Complete the emergency contact section with the name and phone numbers of the individual you wish to designate as your emergency contact.
6. Next, provide information regarding your insurance coverage. Fill in the primary and secondary insurance sections with the name of the insurance companies, the subscriber's name, policy IDs, and any other relevant details.
7. Carefully read the financial policy statement at the end of the form. Acknowledge your understanding by providing your signature and the date.
8. Review all the information you have entered for accuracy. Ensure that all required fields are completed.
9. Once satisfied with the information, you can save your changes, download the completed form, print it if necessary, or share it with the healthcare provider.

Complete your new patient forms online today to ensure a smooth start to your healthcare journey!