To save time in our reception area ~~ please fill out the following forms prior to your arrival:
Release Forms
- Permission to treat a Minor: Hillside Family Medicine must receive permission from a child’s parent or legal guardian before providing treatments for an injury or illness that is non-life threatening. This form gives us legal permission to treat your child in case you cannot accompany him/her to the clinic for treatment. If the party accompanying your child (baby-sitter, friend, relative, etc.) does not present this information the clinic will attempt to contact you to request permission to treat your child. If unable to reach you the appointment may be rescheduled. Thank You.
- Medical Records Release: Please fill out and submit for all medical records requests.
Clinic Forms
Please fill out the following forms if requested/relevant:
- Anchorage School District Physical Form
- Zung Depression Evaluation
- Mood Disorder Evaluation
- Medication Dispensary ~ Patient Information Form
- Superior Energy Physical Form
