Black Mountain Family Medicine

Dr John Bickle

Forms

New Patients to the office please complete these two forms:

• Patient history Form
• Registration_Form

Established Patients with any change in information (name, address, insurance):

• Registration_Form

Records Release Form to transfer your records to our office from another office, hospital or medical facility:

• Medical_Records_Release

Notice of Privacy Practices:

• Privacy Practice

Notice of Office Policies:

• Office Policies

These forms require Adobe Acrobat Reader.