Thank you for putting your trust in Secure Health Medical Group for your health care needs. To help us update your medical record, we encourage you to complete the forms below prior to your first visit with us. You can download forms all at once or specific forms individually.

 

If you need help, please don’t hesitate to send us a message!

 

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• All Patient Forms– English

• Formularios Para Pacientes– Español

• Patient Information Form

• Responsibility for Payment and Receipt of HIPAA Notice Form

• Notice of Privacy Practices

• Designation of Personal Representative

• Consent for Treatment

• Authorization for the Release of Protected Health Information

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