March 19, 2020
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New Patients
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Alpha Medical Centre
New Patients
We are honored that you are considering Alpha Medical Centre to be the solution to your healthcare needs. For your convenience, we have provided these forms in order to get to know you better before your first visit.
Patient Registration Form*
Medical History Form*
Financial Policy Agreement*
Information Questionaire*
Patient's Rights and
Responsibiites Pamphlet
HIPAA Privacy Policy
* Forms and agreements denoted with this marker are required to be submitted upon your inaugural visit.
You may print and fill out these forms at home in order to have them ready to submit upon your visit.
Alternatively, we can provide you these forms during your first visit.
☎ Questions? Give us a call.