Plaza Park Family Practice Services
- Accidents/Injuries
- Acne Treatment
- Allergy Testing
- Attention deficit disorder & depression
- Back or neck pain injections
- Blood tests-lab work
- Cardiac stress testing
- Gynecology and routine female examinations
- Headaches
- Immunizations
- IV therapy
- Male Physicals
- Newborn and well child care
- Orthopedics
- Pain management
- Ultrasound testing
- Weight Loss
Plaza Park Family Practice Patient Resources
Welcome to our practice! We look forward to meeting you and serving your healthcare needs. Your new patient forms are important forms that need to be completed prior to your first visit. Please print off the forms, fill them out completely, and bring them with you to your appointment. Please also bring your photo ID, your insurance card(s) and your co-payment, if applicable. There should be 7 different forms to print off and bring in.
Forms to fill out and bring into the office are as follows:
- Insurance/Personal Information form
- Authorization Release Form
- Personal Representative (if applicable)
- Copying records form
- Privacy Form
- Transfer Form (if you are switching doctors)
- New patient assessment sheets. Depending on whether you are an adult male, adult female or a child will determine which form you choose. Males and Females age 13 and above need to fill out the adult forms.
~Tracey Hill, Practice Administrator
New Patient Forms
Insurance/Personal Information Form
Personal Representative Form (if applicable)
Please choose from the following new assessment forms:
Child Assessment Form (Ages 12 and Younger)
