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