Forms & Information

Providence Medical Group wants to help ease the way of our patients by providing new patient medical forms and privacy notice information in advance of their first visit. 

Please review all of the information below and complete the necessary forms prior to any patient’s first appointment to allow for quick and easy processing.

Complete these forms: (See links below)

  • Providence Medical Group Health History Form 
  • Medical Records Transfer Form

Review this information: (See links below)

  • Notice of Privacy Practice
  • Genetic Privacy Notice

Forms Instructions

Health History Form - Gateway Internal Medicine

Please complete this medical history form prior to the patient's first appointment.