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We've tried to make the new patient process as easy as possible by
providing all of the forms required here on the LCFP website. Descriptions
of the forms follow. Links to the forms appear to the right. You can print
them out, complete them and bring them to your first appointment at LCFP.
All new patients must complete all of the following forms:
Notice of Privacy Practices -
we are required by law to maintain the privacy of your personal health
information and to provide you with notice of LCFP legal duties and privacy practices.
Acknowledgement of Privacy Practices -
you are required to acknowledge receipt of the above-mentioned Notice of Privacy Practices.
Financial Policy - so there are no
surprises later. You're required to read and acknowledge the LCFP Financial Policy.
Patient Registration Form - all the
necessary facts and authorizations.
Health Questionnaire - your medical
history, allergies and more. Your input here will help us to treat you and to understand
your current state of health.
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