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Patient forms

Here are the forms to complete before your appointment. 

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We want to be sure we have your most recent information. Print and complete the following forms and bring them to your appointment.

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 Patient registration form

This is for new patients; please be sure to complete it before your first visit. It will give us important information about your health.

 Formulario de registro del paciente

Esto es para nuevos pacientes; asegúrese de completarlo antes de su primera visita. Nos dará información importante sobre su salud.

 Medical history form

Use this form to give your doctor information about your medical problems and your family's medical problems.

 Medical history form – endocrinology patients

If you are a new patient to endocrinology, please use this form to give information about your medical problems and your family's medical problems.

 Medical release form

Use this form to have your medical records sent to OptumCare Medical Group (OCMG), or to have OCMG send your records to another medical group. 

 Protected health information and privacy form

Use this form to give OptumCare Medical Group permission to share your medical information with others.

 Formulario de divulgación de información protegida de salud

Use este formulario para autorizar a OptumCare Medical Group para compartir su información médica con otros.

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