Patient Agreements & Authorizations
• Sound Family Medicine Patient Agreement
• Notice of Privacy Practices Acknowledgement
• Authorization for Consent to Treat a Minor Child
• Power of Attorney Form
• Authorization to Release or Disclose Healthcare Information
• Records Cancellation Form
• School Sports Physical Form
• Blood Pressure Measurement Log
• Blood Sugar Measurement Log
• Patient History
Forms Fee Policy Update
Starting November 7th, 2022, we will be collecting a fee to complete forms from patients requesting paperwork to be filled out by their provider.
What kind of paperwork and forms do this new policy refer to?
- Adoption/foster parent physical
- Disabled parking pass
- Employment physical
- Family medical leave (FMLA)
- School or camp physical
- Pre-operative forms
How much do you charge for forms request?
- If your form is 2 pages or less (each side is considered a page), the form fee is $25.
- If your form is more than 3 pages, the form fee is $50.
Fees are due at the time of drop-off. This is not a covered item by the insurance company.
Is an appointment required to request for forms to be filled out?
If you had a recent visit pertaining with the same diagnosis, you can drop off your forms to our Front Desk staff. Your provider may still request to see you in an office visit to discuss your health concern pertaining to the form.
If your form is related to a healthcare issue that has not been discussed with your provider, you must schedule an office visit first.
What is the turnaround time?
Completion of forms may take up to seven (7) business days, excluding an office visit day if deemed necessary.
Why are we implementing this policy?
We have received an influx of forms requests. Completing a form takes some time and legwork/research that often times run over our regular business hours. This work is not billable to the insurance companies. Charging for forms paperwork is the norm for other medical facilities. We are the last ones in the area to do so. We understand that to some this may not be ideal and may pose a hardship. We commit to being transparent with you and work with you to meet your needs. We request for your understanding, and we are grateful that you continue to choose us as your primary care providers.