Forms / First Visit

Forms

You may download copies of our forms here to review and complete in advance of your appointment:

1. HIPAA (Read Only)

2. MFD Financial Policies

3. Minor Consent (Read Only)

4. Minor Consent Form

5. Health & Medication History

6. Telemedicine Consent

7. Release to Family Authorization

8. Record Release Request

Your First Visit

Bring with you:

• A valid photo ID.
• Your insurance card(s), both for your primary and any secondary insurance.
• A complete list of your current medications, or the medications themselves.
• If you’ve completed any of the above forms, please bring them with you as well.

Please review our map so you can find our location.

Keep our phone number handy in case you get lost: (425) 654-1275