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Family Medicine Clinics

Quillen College of Medicine

New Patient Information
If you or other members of your family are coming to our office for the first time, it is important that we obtain certain medical information which will enable us to provide the best medical care in the event of an illness or emergency. You may be asked to sign a "release of information" form to allow our office to obtain copies of past medical records for you and your family. You will also be asked to sign forms giving us permission to bill your insurance company for your visit to the clinic and/or during your stay in the hospital. Our office staff will be happy to assist you in providing this information to us.

When you arrive at our office, please register with the receptionist. You will need to update or provide current information about your address, telephone number and insurance. This information will be used to establish and maintain your medical record. All information in your medical record will be maintained in a confidential manner and will not be released to anyone outside of our office without your written permission.

One of our nursing staff will call you from our reception area to an examination room. You will be given an "encounter" form as a record of your visit. Please return this form to the checkout desk before leaving the building.
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