Alamo City Medical Group | San Antonio, TX

Patient Forms

This page provides links to Standard Patient Forms in Adobe Acrobat PDF form. When you click on a link the form will appear on your screen and you will be able to print the form. If the page does not display you may not have Adobe Acrobat PDF Reader loaded on your computer. Click on the Adobe Button at the bottom of the page for a free copy of the Adobe Acrobat PDF Reader.

	Release of Medical Information	The Release of Medical Information form is a standard form that should only be completed if you would like your prior medical records to be transferred over. Then this form must be completed prior to your first appointment.
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	Privacy Policy
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	Discharge Summary
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	New Patient Information Record	The new patient information record is a standard form and must be completed prior to your first appointment.
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	Consent For Treatment	The consent for treatment form is a standard form and must be completed proir to your first appointment.
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	Financial Policy	The financial policy is a standard form and must be completed prior to your first appointment.
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	Assignment of Benefits	The assignment of benefits form is a standard form and must be completed prior to your first appointment.
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	Adult Confidential Health History Form	The Adult Confidential Health History Form is a standard form and must by completed prior to your first appointment.
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	Adult Confidential Health History Form	The second page of the Adult Confidential Health History Form is a standard form and must be completed prior to you first appointment.
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