Friendly Urgent and Family care 
     Here are some forms you'll need when visiting our office...

Computer Picture
Download and print the form you need:

Patient registration Form

Notice of Privacy Practices

E-Prescribing 2016

HIPAA 2016

Medical Information Release Form 2016

Patient History Information 2016

STATEMENT_OF_PATIENT_FINANCIAL_RESPONSIBILITY2016

UA Wellness Sheet 2016

You will need to have Adobe Reader installed in order to read and print these forms. If you don't have it, you may download it free from this link: Download Adobe Reader Free