Patient Resources > Patient Forms

Patient Forms

For your convenience, please download and complete the forms below.  Once finished, email them to us at office@dublin-medical.com or bring them along to your appointment.

New Patient Packet

Download and bring this packet to your visit at our practice.

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Patient Info Sheet

Tell us about you and how we can best contact you.

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Financial Policy

Learn about your financial rights and responsibilities when receiving care from our practice.

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Record Request

Authorize the practice to request your medical records from elsewhere.

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Record Release

Authorize the practice to share your records with an external person or organization.

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Privacy Policy

Learn more about how we protect your private medical information.

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No Show Policy

Read more about what happens when you fail to show for an appointment.

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No Surprise Act

A notice about your rights when it comes to surprise billing.

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Medicare Primary Care

Learn to how to set us as your PCP for Medicare.

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