NEW PATIENTS -

• Don't forget to bring your photo ID and your insurance card!
• Please fill out and/or sign the following three documents and bring to your appointment:

           - New Patient Medical History Form

            - Demographics Form

                - HIPAA Notice of Privacy Practices

Other Patient Forms:

• If you are coming in for your annual exam and you have already seen Dr. Powell , please fill out the EXISTING PATIENT MEDICAL HISTORY FORM                                
• If you would like to authorize Dr. Powell to discuss confidential medical information with a family member, please fill out and sign the AUTHORIZATION TO DISCUSS MEDICAL INFORMATION 

After printing the above forms from your printer, simply complete and bring with you to your appointment.  If you have any questions, please contact us at the Oxford office (248) 236-0840.

Confidentiality and Medical Records: 

All your medical records are considered confidential information. We will release the records or any part of them only if you give us written authorization. No matter what the circumstances, we will not release these records unless we have written notification that you wish us to do so.

To view our HIPAA Notice of Privacy Policy, click here