BayCare Medical Group Patient Forms

To help reduce your wait time in our office, you can print and complete some forms prior to your appointment and bring them with you to your office visit.

New Adult Primary Care Patients

Please print and complete all five forms below.

• Patient Registration
• Patient Consent
• Patient Consent (Spanish)
• HIPAA Consent
• HIPAA Consent (Spanish)
• Financial Responsibility
• Financial Responsibility (Spanish)
• Adult Health Information Questionnaire

New Pediatric Primary Care Patients

Please print and complete all five forms below

• Patient Registration
• Patient Consent
• HIPAA Consent
• Financial Responsibility
• Pediatric Health Information Questionnaire
• Pediatric Health Information Questionnaire (Spanish)

Supplemental Forms for Specialty Care Patients

Breast Surgery

• Breast History

Cardiac, Vascular & Thoracic Surgery

• Cardiovascular History

General/Colon & Rectal Surgery 

• Colon and Rectal Medical History
• Colon and Rectal Family History 

Interventional Cardiology - Procedure Instruction Forms 

• Dobutamine Nuclear Stress Test
• Dobutamine Stress Echocardiogram
• Lexiscan Nuclear Stress Test
• Nuclear Exercise Stress Test
• Regular Exercise Stress Test
• Stress Echocardiogram

Neurological Surgery

• Neurological Medical History
• Describe Complaint

Other Forms

• Adult Annual Physical
• Advance Directives - English
• Advance Directives - Spanish  
• Authorization to Release Medical Information - English
• Authorization to Release Medical Information - Spanish
• How To Be An Effective Partner in Your Healthcare