The 5 forms listed below are necessary for your initial visit.  We have tried to make it easier for you to print these forms out on your printer, fill them out and bring them with your to your scheduled appointment.

This will save you approximately 30 minutes of waiting room time.  We want to take care of your medical needs as soon as possible and we think this will help speed up the process.

Follow these steps:

Click on the links below and the form will appear.

Print the form out on your printer.

Fill out all of the forms as complete as possible.

Sign all forms that require your signature.

Bring them to your scheduled visit at Howell Family Care.

FORMS

*Notice:  Please use Black Ink Only when filling out the forms.

New Patient Information Form

Patient History Form

Financial Policy Form

Results & Receipt of Privacy Practices Form

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Thank you for your efforts and support.  We look forward to seeing you!

Howell Family Care