This page contains links to, and information concerning, forms available on this Web site. This includes both ONLINE-FILLABLE FORMS and
ONLINE-NON-FILLABLE FORMS as noted.
Please see instruction below for the fillable forms.

• Patient Registration (Complete on computer then print)
   

• Medical Questionnaire (Complete on computer then print)
   

• Request Records From Previous Physician To Go To Parkview
  Complete on computer then print, sign and mail)
   

• Information and Forms To Send Parkview Records Elsewhere
  Complete on computer then print, sign and mail)
   

• Patient Centered Medical Home Letter
   

• Patient Centered Medical Home Opt-Out Letter
  (Must print to complete)
   

• Blood Pressure Journal
  (Must print to complete)
   

• Blood Sugar Journal
  (Must print to complete)
   

********************************************************************************************

Instructions for fillable forms
Please Read Prior to Filling Out the Forms

The fillable forms mean that you can type into the form Online. You select each field  by left-clicking the mouse pointer within the field or by using the "Tab" key. When you Tab to a set of Radio buttons only one is selected -- you can select each of them by using your arrow keys or mouse pointer. To reset all fields to blank, reload the form in your Web browser.

Then:

If you have Adobe Reader Version 7.0 or greater:
(if not, upgrade here

1. Using the Menu item File, select 'Save As' and save the file to your computer.
2. Using the free Adobe Reader (7.0 or greater), you may now open this file locally on your computer, edit it, save it again with the same or different file name, and print it out. When it come time to make changes to the information, it can now be brought up on your local computer and the necessary changes made easily .
3. Sign the printed out copy and bring it to our office (we require a signed copy)

Note: Since the filled-in form is now on your computer, it can theoretically, like any file, be sent by Email. However, DO NOT ATTACH TO EMAIL !   because of security implications (medical and personal data such as social security numbers), and since we require a signed copy. Instead, please bring them with you.

If you do not have Adobe Reader 7.0 or greater and not want to upgrade.:

1. You may still type it in, print it out from the Online form, sign it and bring it with you. However, you can not save the form to your computer.  The filled-in version is NOT available anywhere except on the paper upon which you printed it. You may also print out the blank form and fill it in by hand.