Washington Township Medical Group, Inc. :: Fremont, CA
 

 

 
 

These forms are in Adobe's Portable Document Format (PDF). If you do not have the Adobe Acrobat Reader installed on your system, you may download it for free from Adobe's website.

 

 

 
 

 

To save time, you may print the forms and complete them before your appointment, and bring them with you. 

Please remember to bring a current list of your medications, a current insurance card and your co-pay along with your completed forms to your appointment.

New Patient Registration

Notice of Privacy Practices

Acknowledgement of Receipt of Privacy Practices

Screening Questionnaire for Adult Immunization

Screening Questionnaire for Child and Teen Immunization

Financial Policies

 

 

 

 

 

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