Patient Forms

North Okaloosa Physician Group patients and guests can expect confidential, professional service from our knowledgeable and friendly staff. The patient-registration staff will get you registered as quickly as possible, and they will make sure your insurance information is filed correctly to ensure proper billing.

New Patient Forms

Title Download
Digestive Care New Patient Form
  1 files   
  34 downloads


Download
Family and Adult Care
  1 files   
  409 downloads


Family & Adult Care New Patient Form
Gateway Crestview New Patient Form
  1 files   
  275 downloads


Gateway Medical Clinic Crestview New Patient Form
Gateway DFS New Patient Form
  1 files   
  241 downloads


Download Form
OBGYN New Patient Form
  1 files   
  373 downloads


Womens Health Specialists New Patient Form
Pediatrics New Patient Form
  1 files   
  388 downloads


Pediatrics New Patient Form

On your first visit, make sure you bring:
  • A photo ID
  • All your demographic information, such as address, age, etc.
  • Emergency contact information
  • Insurance card(s)
  • Name of your referring physician and a list of any other current healthcare providers
  • List of all your current medications with dosages and nutritional supplements (or bring the actual bottles)
  • List of any medications to which you are allergic or have had adverse reactions
  • Lists of past surgeries/hospitalizations and lab and/or X-ray results, as well as family history; a complete history and physical will be recorded if you are a new patient
  • List of any questions you may have for your nurse or doctor

Please remember to bring a photo ID, your insurance cards and a list of the medications you are currently taking with the dosage to all appointments.

After checking in at the main desk, the staff will notify your physician of your arrival. Please arrive about 30 minutes before your scheduled appointment if you are a new patient and about 20 minutes before your scheduled appointment if you are a returning patient.

During your visit:

  • Ask questions about your diagnosis and care plan.
  • Take notes.
  • Do not leave without a clear understanding of everything discussed.

North Okaloosa Physicians Group