INFORMATION ABOUT   

           PATIENT RIGHTS

    (INFORMACION SOBRE

  DERECHOS DE PACIENTE)

      FINANCIAL RESPONSIBILITY

 (RESPONSABILIDAD FINANCIERA)

              PATIENT RIGHTS

      (DERECHOS DE PACIENTE)

    PHARMACY CONSENT

(PERMISO DE FARMACIA)

      SHARING RESULTS

(COMPARTIR RESULTADOS)

 

PERSONAL INFORMATION

(INFORMACION PERSONAL)

 

MEDICAL HISTORY

(HISTORIA MEDICA)

NEW PATIENT FORMS

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

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.