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
	Patient Registration Form
	Medical History Form
	Questionnaire for Non-OB/GYN Patients
	Authorization to Consent to Medical Care and Treatment of a Minor
	Authorization to Leave Personal Health Information by Alternative Means
	Privacy Complaint Form
	HIPAA Form
	Notice of Health Information Practices
Medical Records	Authorization for Release of Medical Information
Medical Records	Authorization for Release of Imaging Records
Allergy & Immunology	Allergy_Patient_Instructions
	Allergy_Adult_Medical_History_Questionnaire
	Allergy_Child_Medical_History_Questionnaire
Ambulatory Surgery Center	Patient Rights and Responsibilities for the ASC
	Protected Health Information in the Surgery Centers
	"Speak Up" for ASC Patients
Dermatology	Dermatology Health History Questionnaire
ENT	Allergy Packet
ENT	Patient Health History
First Hill Surgery Center	Patient Rights and Responsibilities for the First Hill Surgery Center
	Protected Health Information in the Surgery Centers
	"Speak Up" for First Hill Surgery Center Patients
Imaging	Authorization for Release of Imaging Records
	CT Lung Screening Questionnaire
	DXA Osteoporosis Questionnaire
	MRI Questionnaire
	UGI Small Bowel Questionnaire
	Mammography Worksheet
	HIPAA Form
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.