Forms

New patient forms can be found below. Please make sure you click on each form to view/print and fill out completely before returning the forms to your health center: Bassett Family Practice or Ridgeway Family Health. *IMPORTANT* Please make sure you print, complete and return ALL forms below.

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  1. New Patient Welcome Letter
  2. Prescribing Notice
  3. MedAssist Information
  4. Patient Demographics (2018)
  5. Reduced Fee Eligibility 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