Patient Forms

Please find below the links to 3 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.

***  MAKE SURE YOU FILL OUT ALL 3 FORMS  ***

1. Authorization to Obtain Healthcare Information--New Patients. We will use this form to obtain your outside records before your initial physical.

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

3. 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.