Our Health Forms

Health Questionnaire / Medical History (For first-time patients only).

Authorization for Release of Information

Consent for Release of Confidential Information

Advanced Directives

Office forms at your fingertips

New visitors to Union Medical Group must complete a Health Questionnaire and Medical History form to provide the doctor with your essential health information.

Other forms may be needed in certain instances. For example:

• If you wish to have your records sent to another doctor's office, you will need to complete an Authorization for Release of Information form.

• If you wish for us to provide information to a family member or a trusted friend, you will need to complete a Consent for Release of Confidential Information form.

• If you wish to provide your doctor with advance instruction in case you became ill and could not communicate, you would need to complete an Advanced Directives form.

To access and review any of these forms, simply click on the link below and print it out. If you need to complete any for the office, you may complete them at home and bring them on your next visit to the office.