Please click on the links below to view and print the patient forms. You must also read the “Notice of Privacy Practices”, and print and sign the “Acknowledgement of Review of Notice of Privacy Practices”. Please fill out the forms entirely with all signatures. To help expedite the administrative process and to help ease your wait time, you can either fax them to our office ahead of time (936- 788- 2844) or bring them with you to hand in when you arrive for your scheduled appointment.
Registration and Health Assessment (print, complete and sign)
Assignment of Benefits Form (print, complete and sign)
Preventative & Diagnostic Labs (print, complete and sign)
Medical Records Release Form (print, complete and sign)
Notice of Privacy Practices (READ ONLY)
Acknowledgment for HIPPA Form (print, complete and sign)
PHQ-9 Patient Health Questionnaire (print, complete and sign)
Audit C Alcohol Screening (print, complete and sign)
PA & NP Consent Form (print, complete and sign)
Patient Centered Medical Home Patient Compact (print, complete and sign)
Meet our physicians, who take pride in preventative care for the whole family! Our physicians have a wide range of focus’ that will ensure protection of your well-being and help you prevent disease and disability.
Getting a sports physical each year is imperative in maintaining a healthy, safe and effective training regimen. Our physicians can help you avoid future health issues and injury with a quick and simple sports physical.
Monday – Thursday 7:30 – 5:00
Friday 7:30 – 3:30
Are you staying healthy? Get a wellness exam today.
Prioritize your health and book an appointment today.
AFFILIATES OF
FAMILY MEDICINE
SPRING:
28517 Spring Trails Ridge
Suite 100
Spring, TX 77386
Phone: 281-362-5436
Fax: 281-651-5451
CONROE:
503 Medical Center Blvd
Suite 100
Conroe, TX 77304
Phone: 936-788-1060
Fax: 936-788-2844
©2024 Affiliates of Family Medicine. All Rights Reserved.
