New Patient Information
Thank you for choosing Northwest Primary & Specialty Care for your medical care. New patient forms (as well as other useful documents) may be accessed from this web page.
New Patient Forms:
If you are a new patient, please fill out the patient registration and acknowledgment of privacy notice forms below. Please click on the link to review. If you are bringing a child, please also fill out the parental pre-authorization for minors form.
Below you will find the new patient forms needed for your first visit. Please print, complete all fields and bring with you to your appointment. If you are not a Medicare patient, you do not need to complete the Medicare Wellness Questionnaire. Thank you.
Northwest Primary & Specialty Care
New Patient Registration: Adult
New Patient Registration: Minor
Northwest Cardiology
New Patient Registration: Cardiology
Useful Forms:
If you are interested in filling out a living will and medical power of attorney, those forms are available here for you to print and to fill out. These forms are essential to have in the event you are unable to speak for yourself and require a family member to make medical decisions for you.
What do I need to bring to my appointment?
- Information about any recent hospital stays, lab or diagnostic imaging reports (CT, MRI, mammography, X-ray, ultrasound). If you don't have the report, let us know where the lab or imaging test was performed and we can request the report for you.
- Current medications: name of the medication, milligrams and dosage.
- A list of questions that you'd like to ask your doctor. Often, patients may have a list of questions they want to ask but forget them once they get into the doctor's office. We're happy to answer all of your questions and a written list can help ensure we do.