Print Forms:

 

Note: 2006 forms have changed and this page is pending update:

 

 

 

 

· Patient registration form:   = For all new patients or established with address change

 

 

 

 

 

 

· Short Patient History Form = For those with fewer than 3 medications or 3 medical problems

 

 

 

 

 

 

 

· Long Patient History forms: = For those with 3 or more medications or medical problems

 

 

 

 

 

 

MAGALIA-PINES FAMILY PRACTICE MEDICAL CLINIC