Patient Forms

Please find below the links to three forms. These forms are NOT used to enroll in North Bethesda Primary Care but are supporting documents once you are already enrolled. Only fill out these forms if you are already enrolled in the practice.

All Patients

1. Authorization to Obtain Healthcare Information. We will keep this permission on file for obtaining outside records, if needed, in the future.

2. Permission to Disclose Healthcare Information. Please complete this form if you want us to be able to communicate at any time with another person(s) regarding your healthcare.

Only Patients Who Are New to Dr. Possner

3. Authorization to Obtain Healthcare Information--New Patients. Please complete this form ONLY if you are NEW to Dr. Possner. You should complete it in addition to the above two forms. We will use this form to obtain your outside records before your initial physical.