FamilyHealth Medical Clinic

Patient Resource Center

New Patient Forms

Adult Medical History Form: A pdf version of a medical history form that you can print out, fill in and bring with you to the clinic.

Pediatric Medical History Form: A pdf version of a medical history form for a child that you can print out, fill in and bring with you to the clinic.

Authorization for Disclosure of Medical Information: A pdf version of an Authorization for Disclosure of Medical Information form may be downloaded here. This form may be used to have your records transferred from another medical care provider to FamilyHealth Medical Clinic. Please fill it out, sign it, and submit it to your previous provider.

Health Maintenance Form: A pdf version of a record of your immunizations, lab work and diagnostics that you can print out, fill in and bring with you to the clinic.

Living Will

Health Care Directive: A pdf version of a Health Care Directive form may be downloaded here.

Diagnostic Imaging

The following brochures provide answers to frequently asked questions about common diagnostic imaging procedures. They may be downloaded in pdf format.

Diagnostic Ultrasound

Nuclear Medicine Testing

CT Scanning

MRI Scanning

Upper GI Series

Small Bowel Follow-Through

Modified Barium Swallow or Esophagram

Intravenous Pyelogram

Barium Enema and Air Contrast Barium Enema

Cardiac Stress Tests

To help you learn what to expect from your cardiac stress test, please download one of the pdf files below:

Cardiac Stress Test (Basic Exercise Walking Test)