Change of Address or Insurance
To be completed when your address or insurance has changed.
Patient History Form
Provided at visit time to help ensure proper medical history is known.
Transfer Record to LPMC
To be completed when requesting that your medical records be transferred to LPMC from your previous practice.
New Patient Form
To be completed by all new patients.
To be completed when requesting that your medical records be transferred from LPMC to a new practice.
To be completed when requesting the disclosure of health information
To be completed to receive COVID vaccine