Patient Forms

In order to keep our records current, DDP requires all patients to update their demographics and medication lists at least once every two years. To help speed up what can sometimes be a tedious check-in process, our registration forms are readily available for you to download and fill out prior to your office visit.

Depending on the web browser you use, you may be able to click on the form and fill it out directly, or you may need to download the form first and then open it in Adobe Reader to fill out.

If you do not have Adobe Acrobat Reader installed, you may download it for free by clicking here 

• TELEMEDICINE PATIENT FORMS

  If you have a Telemedicine Visit scheduled, please download and complete the following forms prior to your appointment.

  • HIPAA Form
  • Patient Clinical Forms
  • Patient Self Assessment
  • Telemedicine Waiver
  • Doxy.me Instructions

• ESTABLISHED PATIENT FORMS

  If you are an established patient, please download and complete the following forms prior to your next scheduled appointment.

  • Medication and Allergy List
  • Follow Up Patient Interview Form
  • Established Patient Self Assessment

  • Please fill out the following forms only if you have made any changes to the following since your last visit:

    • Update Established Patient Demographics and Insurance Information
    • Insurance Waiver
    • HIPAA Form
    • Insurance Change Only

  • OTHER FORMS

    • Records Release Form