IKPFM - Patient Resources - IKPFM

IKP FAMILY MEDICINE’S PATIENT RESOURCES

Forms To Assist With Your Visit

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IKP Family Medicine Financial Policy & Patient Consent Form

IKP Community Resource Guide

Release for Treatment of a “MINOR” without a Parent

IKP Family Medicine HIPAA Disclosure Form

Medical Records Request Form

Patient Registration Information

Medication Information Release Form

UIL Pre-participation Sports Physical Form

Immunization Registry Adult Consent Form

Credit Card Authorization Form

IKP Family Medicine – Policies

Immunization Registry Minor Consent Form

Telemedicine Informed Consent

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