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FORMS + POLICIES

We know your time is very valuable! Please feel free to print and complete prior to your appointment.

 

If you have any questions or concerns regarding your privacy, our financial policy, or how we provide care to all without discrimination, please review our policies below!

Doctor's Appointment

NEW PATIENT REGISTRATION

If you would like to join the Hometown Family, please fill out our new patient registration packet.

NEW PATIENT REGISTRATION - SPANISH

If you would like to join our family, and need your registration form in Spanish, please fill out the form below!

Medical Team
Warm Up

2024-2025 SPORTS PHYSICAL FORM

Please fill out completely and bring with your student to their sports physical.

RELEASE OF INFORMATION FROM OUTSIDE PROVIDER

Release of medical records from any outside provider to Hometown Family Health

Medical form with stethoscope
hipaa_edited.jpg

HIPAA NOTICE OF PRIVACY PRACTICE

Your health information and privacy are extremely important to us! This notice describes how we protect and disclose your health information within HIPAA regulations.

HFH FINANCIAL POLICY

This policy describes your rights and responsibilities in regard to payment for our health care services.

Men with Calculator
Group of Friends

NON-DISCRIMINATION POLICY

Here at Hometown Family Health, we provide care to ALL and refuse to discriminate, as described in our non-discrimination policy!

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