Forms

For new and existing patients, there are several forms we may require to have on file to maintain accurate records for you.  These forms are provided in this section to save you time at the front desk when you arrive for your appointment.

Release information to/from Richmond Family Medicine

New Patient Registration Packet

Adult Health History Questionnaire

Medicare Annual Wellness Visit Questionnaire

Medicare Information Packet

Worker’s Compensation Form

Notice of Privacy Practices and Payment Policy

Patient Consent Form - Family & Friends