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  • Find a Provider
  • Insurance
  • About
    • Leadership
    • News
    • Contact
  • Resources
    • Patient Forms
    • Bill Pay
    • Patient Portal
    • Related Links
  • Careers
    • Physicians APRN and PAS
    • Job Postings

Endocrinology Forms

Patient Registration Forms

Please print and complete documents 1-5. Additional paperwork may need to be completed at the office.

  1. Adult Health History Questionnaire
  2. New Patient Registration
  3. Consent for Treatment
  4. HIPAA Disclosure Authorization
  5. Authorization to Release Medical Records or Authorization to Release Medical Records (Español)

Patient Portal

A password-protected Web portal that gives you 24-hour access to certain personal health information from your FPG medical record. For urgent requests, phone your doctor’s office.

 

Call 911 for emergencies

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