Complete this form if you are requesting Victor Health Associates to send your medical information to another doctor/office/or party.
New Adult Patients: Please print and review the information and complete forms. Return a printed copy of forms to the office no later than the date of first visit.
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Important information on how we use or share your information, and your patient rights- in a condensed version.
Complete this form in order for Victor Health Associates to receive medical information from another doctor or office you have seen.
New Pediatric Patient Information and Forms: For patients under the age of 18. Parent/Guardian only must review and complete the necessary forms. Return a to the office no later than the date of first visit.
The Health History Questionnaire is to be completed by all adult patients in the week prior to their scheduled Physcial Exam Appointment. Please bring completed, printed, form with you to the office visit. **Also see instructions for important information on obtaining lab order if applicable.
Important information on how we use or share your information, and your patient rights- the complete version.