PATIENT RESOURCES & CONSENT FORMS

If you are asked to submit any of these forms, please complete and send to intake@primarycarehousecalls.com.

AUTHORIZATION OF RELEASE OF INFORMATION

COMMUNICATIONS AUTHORIZATION

CONCIERGE VIP SERVICES CONTRACT

NARCOTICS AGREEMENT

PELVIC EXAM AUTHORIZATION

SELF-PAY ELECTION FORM & CONSENT TO TREAT

TELEHEALTH CONSENT