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Patient Intake Information
You can streamline your first visit to our office by filling out the following three forms in the comfort of your home before coming in. The Patient Information Form will tell us about you and your insurance. The Health History Form will tell us about what we need to know about your medical history to take proper care of you. This form has been approved for general use by Physicians of Cape Cod. After you fill it out once, you should be able to use it (updated, if necessary) at any other physicians appointment on the Cape.
The Medical Release Form enables us to send information about you to your insurance as they require this to be willing to pay for your care. The form also includes a separate section that will enable you to designate others with whom we may share your medical information. We will not share it with anyone else (except other physicians involved in your care) - see our privacy policy.
In order to print the above forms, you need to have Adobe Acrobat Reader installed on your computer. If you already have Adobe Acrobat Reader, select the form. To print the form, click on the printer icon at the top of the Acrobat Toolbar. Once your form is printed, select file from the browser and choose close.
If you do not have Adobe Acrobat Reader on your computer, click the icon below and follow instructions to download. Once this is completed, follow instructions above for printing.
To download your free copy of Adobe Acrobat Reader, please click on the logo below:
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