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Patient Forms
 

For your convenience, the following registration documents are available for you to download, print, and complete prior to arrival for your physician office visit.

The documents in this section are in PDF format and you will need Adobe Acrobat Reader to view them. To download this software for free, please click here.

All patients should complete all forms included in the following Patient Registration packet:

 

Patient Registration Forms Package

(includes: Patient Registration, General Consent for Treatment, Notice of Privacy Practices Acknowledgement *, Patient Responsibilities & Statement of Understanding, Authorization to Discuss Health Information with Others and/or Leave Telephone Messages)

*VMG Notice of Privacy Practices

Medical History(choose only one of the following forms based on the specialty of the doctor you are seeing for your appointment)

Internal Medicine/Family Practice/Geriatric Medicine

Cardiology

Obstetrics/Gynecology 

Dermatology 

Please bring all completed forms to your physician appointment.

For more information about a Valley Medical Group doctor close to you, call 1-800-637-1136
Choose a physician or surgeon backed by the award-winning care of Valley Health System. Choose Valley Medical Group. 
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