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In an effort to make your appointment check-in process smoother and more efficient, here you can find a number of forms that you may fill out in advance of your appointment.
- Adult Comprehensive Health History
- Pediatric Comprehensive Health History
- Sharing Information with Family and Friends
Authorization to Disclose or Release Health Information
If you want to have a medical record transferred from another doctor’s office to your new ¸Û°Äͼ¿â Martha Jefferson Medical Group office, please complete this form. Likewise, this form can also be used to authorize someone other than you to have access to information about your healthcare status on treatment. Just print and complete the form and bring it with you to your next appointment.