Online Forms

(click to download)

  • Yearly History Update - This is the form Dr McMillan wants her patients to fill out for every 30 minute appointment (Preoperative exams, Paps and Physical).
  • HIPAA
  • HIPAA Revocation - When you are revoking an okay to release your protected health information to someone, you will need to fill out this form and also fill out another HIPAA form.
  • Worker's Comp Form - If your office visit is due to a work accident, please fill out the appropriate information on this form and bring it with you to your appointment.
  • Auto Injury Form - If your office visit is due to an auto accident, please fill out the appropriate information on this form and bring it with you to your appointment.
  • Release of Information - If you would like your records sent somewhere outside of our office we will need this form sent in to us completed.
  • Medicare Authorization
  • Complaint Form- This form allows you to submit a complaint in writting to the clinic. A staff member will follow up on the complaint. Complaints may also be called in to the clinic.

 

NEW PATIENTS - Here is the New Patient Packet that is to be filled out prior to your initial appointment. Please make sure to have these completely filled out and bring them with you to your scheduled appointment.

 

Handicap Parking Permits are now completed online through the DMV. If you need to renew your handicap parking permit please contact the office to speak with your physician's nurse/medical assistant.