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Patient Forms
All of our forms are PDFs. They can be downloaded, completed, and then submitted using the below options. NOTE: the Sliding Fee Applications must be printed, completed/signed, and then returned to your Palms Medical Group preferred location.
Before downloading the forms, you may need to get the appropriate PDF AdobeReader® software.
Forms to download and complete:
Please email medicalrecords@palmsmg.org to submit the following forms:
- Patient Registration Form
- Medical Records Form
- Dental Medical History Form
- Chiropractic Form
For Sliding Fee Applications, please print the above-linked form, complete and sign it, and return it to your Palms Medical Group preferred location.
