Forms for Download
(Click to Download Forms Below)
Forms for first visit:
- Privacy Notice
- Patient Information
- Medical History
- Personal Health History
- Records Release Authorization
- Health History Questionnaire
- Personal Habits
- Medical Records Release (Last Physician to CFPC)
- Medical Records Release (CFPC to other Physician)
- New Management Rules
Other forms:
- Respirator Medical Questionnaire
- Consent Form for HIV Test
- Influenza Vaccine Consent Form
- Medical Records Release (CFPC to other Physician)
Participating Insurance Companies:
- Aetna
- Amerigroup/InTotal
- Anthem BC/BS
- CareFirst
- Cigna
- Medicaid
- Medicare
- OneNet
- PHCS
- Tri-Care
- United Healthcare