Patient Info

Getting Ready for Your Visit

At Minor & James Medical, we want your visit to be as easy as possible. In order to speed up your check-in process, we encourage you to fill out any applicable forms before your appointment and turn them in to your patient services representative at time of check-in.

In order for us to provide the best care for you, it is very important that you bring the following items to your visit:

Photo ID
A list of your current medications
Any and all x-rays films
Insurance information and card
Information about what treatments and medications have been tried in the past
Medical records from prior visits that you think may be helpful
New Patients: download a patient registration below

Download Patient Forms

To view the forms listed below, you will need Adobe Reader. You may download Adobe Reader for free at www.adobe.com. Please bring your completed forms with you to our office at the time of your visit.

General Patient Forms	New Patient Packet
	Minor and James General Registration Form
	Adult Health History Questionnaire
	Authorization to Consent to Medical Care and Treatment of a Minor
	Authorization For Disclosure Of Protected Health Information
	Minor and James Notice of Privacy (HIPAA)
	Minor & James Financial Policy Brochure
Medical Records	Authorization For Release Of Personal Health Information
Medical Records	Authorization for Release of Imaging Records
Allergy & Immunology	Allergy Patient Instructions
	Allergy_Adult_Medical_History_Questionnaire
	Allergy_Child_Medical_History_Questionnaire
Dermatology	Dermatology_Health_History_Questionnaire
Endoscopy Unit	Patient Rights and Responsibilities (Endoscopy Unit)
Endoscopy Unit	Protected Health Information (Endoscopy Unit)
ENT	Allergy Packet
ENT	Patient Health History
First Hill Surgery Center	Patient Rights and Responsibilities FHSC
First Hill Surgery Center	Protected Health Information in the Surgery Centers
Imaging	Authorization for Release of Imaging Records
	CT Cardiac Calcium Scoring
	CT Lung Screening Questionnaire
	CT Screening Form
	DXA Osteoporosis Questionnaire
	Exam Prep instructions
	Mammography History Worksheet
	MRI Screening Form
	UGI Small Bowel Questionnaire
Obstetrics & Gynecology	Questionnaire 1 for OB/GYN Patients
	Questionnaire 2 for OB/GYN Patients
	Routine Preventative Care Disclosure Agreement
Orthopedics & Podiatry	Orthopedics_Podiatry_Medical_History_Form
Rheumatology	Medical History Form for Rheumatology

IN THIS SECTION

Patient Info

Cervical Cancer Screening

Cervical cancer screening is the best way to catch cervical cancer early or even prevent it altogether.