Welcome to our "Registration Forms" page. Kindly download and fill out the
appropriate forms below when arriving at East Hampton Family Medicine for an appointment.
Adult Registration
For first-time adult patients, kindly download the Form to the right; fill it out, and give it to the receptionist when signing in.
Additionally please have the following information with you:
- A copy of your insurance card, front & back
- A copy of your photo I.D.
- If possible - records from previous medical providers
Pediatric Registration
For your child's first visit, kindly download the Form to the right; fill it out, and give it to the receptionist when signing in.
Release of patient information
To authorize the release of your medical information, please download the Form to the to the right. (George - I need information as to what the protocol is for sending in the form, whether it's mailed in first or it must be dealt with in person in office.)
Authorization to obtain patient information
To obtain your medical records from another doctor's office, hospital, or medical provider, please download the Form to the to the right. (George - I need information as to what the protocol is for sending in the form, whether it's mailed in first or it must be dealt with in person in office.)