Should you choose to postpone registering on the Patient Portal at this time, you may print the below documents and bring them completed to your first appointment.

The document below are provided in a printer friendly PDF format. A PDF viewer such as Adobe Reader is required to view the documents and can be downloaded free by clicking on the image at the bottom of the page.

Patient Profile
This form provides us with basic patient information as well as insurance information and emergency contacts.

Medical History
The Medical History Questionaire provides us your medical history, alergies and medications to better treat you.

Financial Policy
As part of our commitment to you, MPFC feels it is important that you understand your financial responsibility. MPFC's policies are listed in the linked document. If you have any questions, please ask one of our staff to direct you to the Business Office for assistance.

Privacy Practices
This notice describes how health information about you may be used and disclosed and how you can get access to this information. It is effective April 14, 2003 and applies to all protected health information contained in your health records maintained by us. We have the following duties regarding the maintenance, use and disclosure of your health records.

Medical Records Release
Authorization to use and disclose health information.

Medicare Resources
This is a list of clinics currently accepting new Medicare and Medicaid Patients. Medical Park Family Care currently is NOT taking any NEW Medicare or Medicaid patients. We continue to see our established patients with this coverage.

Employment Application
Medical Park Family Care consists of over 77 employees, ranging in fields from doctors, nurses, clerical and occupational health. Full time position benefits include: Medical, Dental, 401K, Profit Sharing, and Paid Leave. We are an equal opportunity employer. Click here to view current job postings.