Forms

New patient forms

Please make sure you click on each form to view/print and fill out #1 – 11 completely before returning the forms to Bassett Family Practice or Ridgeway Family Health.

1. New Patient Welcome Letter
2. Prescribing Notice
3. MedAssist Information
4. Patient Demographics
5. Reduced Fee Application
6. History Questionnaire
7. Authorization for Release of Information
8. Cancellation Notice
9. Consent to Treat
10. Patient Portal Guidelines
11. Notice of Privacy Practices/HIPAA