Patient Forms
For your convenience, we’ve provided our clinic forms for you to download, print, and complete prior to your visit.
Patient Forms
- Chief Complaint and Present Illness
- Past Medical History
- Review of Systems
- Authorization for Release of Medical Information
- Patient Registration Form with Insurance Card(s) and Picture I.D.
The free Adobe PDF reader is required to view the forms.
New Patients
Please download forms 1-5 and fill out prior to your appointment. The most time consuming form for many is form #2 (Past Medical History). If you have this information already written down, bring it with you and we will copy it for our records. In addition, if you have a Skaggs Physician, he/she may have form #2 information that we can runoff for your chart.
All Return Patients
- Fill out form 1 and 3
- Will will runoff forms 2, 4, and 5 for your review and signatures.
If you DO NOT KNOW your medicines by name and dose, please bring them with you or you may bring in an updated list. Do not assume we can find them in a timely manner from your Primary Care Doctor.