If you are a new patient, if you have moved since your last visit, or if you have changed insurance carriers recently, download our Registration Form and Patient Authorization Form from the links below.

Do you need your old medical records transferred to our office? Download our Authorization to Release Healthcare Information Form from the link below.

INSTRUCTIONS:

1. Click on the link to download the forms. They will open in a new window in your browser.
2. For the Registration Form, click into the “Patient Name” field to begin filling out the form.
3. Save the file to your computer.
4. Send an e-mail with your forms as attachments to appointments@premierinternalmed.com before your appointment date.
5. We will obtain signatures for all requiring forms upon your arrival for your appointment.