Eastern Medical Health Group
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Patient Forms



As a way of making your first visit with us as pleasant and smooth as possible, please download, print and fill out the following forms. Bringing  these forms with you on your first visit allows us to attend to you much sooner since you won't have to fill them in at that time. If there are questions you don't understand or need further clarification about, go ahead and leave those questions blank and let the physician know. You'll be able to answer them at the time of your visit. Thank you.
medical_history_checklist.docx
File Size: 122 kb
File Type: docx
Download File

medical_history_checklist_2.docx
File Size: 97 kb
File Type: docx
Download File

patient_data_sheet_-_blue_sheet.docx
File Size: 80 kb
File Type: docx
Download File

notice_of_privacy_practices.docx
File Size: 114 kb
File Type: docx
Download File

informed_consent_form.docx
File Size: 151 kb
File Type: docx
Download File

payment_policy.docx
File Size: 124 kb
File Type: docx
Download File


Schedule Online

As an added convenience, we offer our patients the opportunity to schedule appointments online. We understand that sometimes patients forget to call to make appointments or health issues occur unexpectedly outside of regular office hours and we need to see our physicians as soon as possible. For this reason scheduling online is available to our patients 24/7. You'll receive a confirmation of your appointment as soon as the calender is reviewed during the first hour of the next business day. ***Please understand that booking your appointment time online is not a guarantee that the requested time will be available. If the time slot you requested is already booked, you'll receive an immediate call, text or email (depending on the method of communication you've chosen) as soon as the calendar has been reviewed to help you reschedule to the next convenient time for you. 



Please click on the box above and follow the instructions to schedule an online appointment. Thank You!
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