Online Forms and Policies FAQ:
New Patient Form: New Patient form for individuals to fill out who are new HIMG prior to the first appointment.
Financial Policy: Answers questions regarding patient and insurance responsibility for services rendered.
Medical Records Release: Medical Records Release for patients to fill out and sign for release of their individual medical records for other physicians
and personal use.
Protected Health Information Release to Family Members: Release for patients to sign for family members or designated individuals to receive Protected
Health Information (PHI) on in person, on the phone or electronically.
Request for Confidential Communications
: Request for patient to receive alternate forms of communication from HIMG for reasons of confidentiality.
Parental Consent for Treatment of Minor Children : Grant permission for responsible adult to seek medical care for your minor child in your absence.
Annual Wellness Visit Forms : Prepare for your upcoming Medicare Wellness Visit.
HIMG Center for Heart Function Blood Pressure Log : Assist your provider in treating your heart by tracking your blood pressure readings.