Forms

In order to make your experience at Essential Med Clinic as efficient as possible, please download and complete the following forms (if applicable) and bring them to your appointment.  This will help ensure we have all the necessary information prior to your scheduled appointment.

New Patients:

Please complete the following forms and present them to our staff when you arrive.  In addition, please bring a list of any medications you are currently taking, a picture ID and your insurance card(s).

Patient Registration Form (.pdf)
Notice of Privacy Practices (.pdf)
HIPAA Form (.pdf)
Medical Records Request (.pdf)

If you have any questions, please feel free to contact us at (210) 568-7555.  Thank you again for choosing Essential Med Clinic.