Forms and Resource Links The following links have been provided for your convenience, simply click on the name below: American Medical Association Centers for Disease Control & Prevention American Heart Association American Diabetes Association National Suicide Prevention Lifeline New York State Smokers' Quitsite Language Resources ------------------------------------------------------------------------------------------- Family Care Physicians Forms:  Family Care Physician's Privacy Policies (HIPAA) A copy of our practice's privacy policies that we encourage all patients to read and keep for their record. Patient Information Sheet Please fill out and sign this patient information sheet prior to your first appointment. Patient Medical & Family History Form Please fill out this form as completely as possible prior to your first appointment. Annual Wellness Visit Info Letter An explanation of the Annual Wellness Visit. Medicare Health Risk Assessment Please fill this out and bring to your Medicare Annual Wellness Visit. Weight Monitoring Log A useful log for patients who are tracking their weight. Medication Form A helpful form to keep all your medication information in one place. Smoking Quiz A questionnaire that will help patients decide which reasons are important in their smoking. Blood Sugar Log Use this log to record your blood sugar readings. Home Blood Pressure Diary Use this diary to record your home blood pressure results. Advanced Care Planning Guide A guide to help with advanced care planning and decisions. Includes NYS Health Care Proxy form. Financial Policy 2020 Please read over and sign this description of our office's financial policy prior to your first appointment. Authorization to Release Health Information Form 2020 Please fill out and sign this authorization in order to have medical records sent to or from our office.