INFORMATION ABOUT   

           PATIENT RIGHTS

    (INFORMACION SOBRE

  DERECHOS DE PACIENTE)

    PHARMACY CONSENT

(PERMISO DE FARMACIA)

              PATIENT RIGHTS

      (DERECHOS DE PACIENTE)

IF YOU WOULD LIKE TO FILL OUT THIS INFORMATION ELECTRONICALLY PLEASE GO TO PATIENT PORTAL TAB FOR MORE INFORMATION.  ONLY THE FORMS LABELED "ON PATIENT PORTAL" ARE AVAILABLE AT PATIENT PORTAL.

IF YOU WOULD LIKE TO PRINT THESE FORMS TO FILL OUT,   PLEASE PRESS EACH TAB AND HAVE THEM FILLED OUT PRIOR TO ARRIVING TO YOUR APPOINTMENT.

                                        PLEASE BRING YOUR ID AND INSURANCE CARD ON THE DAY OF THE APPOINTMENT.

GENESIS FAMILY CARE, P.A.  ELIZABETH ALVAREZ, M.D

      SHARING RESULTS

(COMPARTIR RESULTADOS)

 

      FINANCIAL RESPONSIBILITY

 (RESPONSABILIDAD FINANCIERA)

NEW PATIENT FORMS

PERSONAL INFORMATION

(INFORMACION PERSONAL)

 

MEDICAL HISTORY

(HISTORIA MEDICA)