Get New Patient Information Packet - The West Clinic

Completing the New Patient Information Packet for The West Clinic is a crucial step in ensuring your first visit is as seamless as possible. This guide will provide you with clear, step-by-step instructions on how to accurately fill out the packet online, covering all necessary sections and fields to prepare for your appointment.

Follow the steps to effectively complete your new patient information packet.

1. Use the ‘Get Form’ button to access the New Patient Information Packet and open it in your preferred editor.
2. Begin by filling in your patient name and date of appointment at the top of the form. Ensure that all details are accurate, as this will help streamline your check-in process.
3. Complete the section for the physician's name. This is typically the doctor you have been referred to or plan to see during your appointment.
4. Proceed to input your personal details in the Patient Information Form. This includes your date of birth, social security number, gender, marital status, and contact information. Make sure your information is current and matches any identification you bring.
5. Fill out any insurance information as required. Include the primary and secondary insurance details, including policy numbers and policy holder information, if applicable.
6. Complete the Medical History and Breast History forms as applicable. Indicate any current medical conditions, allergies, surgical history, and significant family medical history, as this information is vital for your ongoing care.
7. If applicable, fill out the Patient Representative Identification Form to designate anyone you wish to allow access to your medical information.
8. Review the financial policy and sign to acknowledge your understanding of the terms regarding payment for services received.
9. Conclude by signing the acknowledgment of receipt of privacy notice. This confirms that you have received The West Clinic's Patient Privacy Notice.
10. Once the entire packet is filled out, save your changes. You may then download, print, or share the document as needed, ensuring that you also bring the form to your first appointment.

Complete your New Patient Information Packet online today to ensure a smooth and efficient visit to The West Clinic.