Forms we use

New Patients

Medical history forms are unpleasant and tedious but turn out to be critical to good care. There are many errors in every patient's medical chart. Your attention to completing this form accurately allows us to start with your true medications, allergies, and so on.

Please enter your medications as you are actually taking them! For example, if a bottle says 3 times daily but you are only taking that pill twice daily, we need to see it as twice daily.

New patient packet  (has all the forms needed for a new patient)

        Components of the new packet may be needed later for changes
           Medical history
           Your communication preferences
           Permission to use email 
           Privacy practices
           Your acknowledgemt of receiving our privacy practices
           Medical records release (so others will send your records to us)

Other forms

For now, we list only the MOLST,  a Mass state government form regarding life sustaining treatment preferences. In our practice this is a discussion, not a form, but the form is helpful for some people after that discussion.

MOLST form (medical orders for life sustaining treatment)