Adult New Patient
For adults (age 18+) with a new patient appointment

Pediatrics New Patient
For children (age less than 18) with a new patient appointment

Financial Policy
Explains payment of services

Notice and Receipt of Privacy Practices (HIPAA)
HIPAA requires all patients to complete this form. Describes how medical information about you may be used and disclosed and how you can access this information.

Medical Release
Form authorizing healthcare provider to release your medical information to Saint Francis Medical Partners

Medical Information Release
Authorizes Saint Francis Medical Partners - Bartlett to release your medical information to specific entities.

Frequently Asked Questions
HIPAA as it relates to our patients.

Red Flags Payment Permission Form
Form authorizing a patient the use of Medical Flex card, personal credit card, or personal check to pay for the services that they receive at Saint Francis Medical Partners

Request for Correction / Amendment to Record
Allows you to request a correction / amendment to your medical record.

Know Your Benefits
This pamphlet can assist you in learning about your insurance benefits, including questions to ask your provider.