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Online Forms

Save time when you register as a new patient. You can fill them out in the comfort of your home and bring them with you to your appointment.

Auto Accident form (PDF)
Financial Assistance Application (PDF)
DFMC Patient Health History Form
My Medication List (PDF)
Patient Information & Authorization form (PDF)
Parental / Guardian Consent to Treatment of a Minor (PDF)
Release of Medical Information (PDF)
Worker’s Compensation Claim (PDF)
Authorization to Discuss your Health with Others (PDF)
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