Antelope Creek
Family Physicians

Patient Forms

For your convenience, Antelope Creek makes these forms available online. Filling these out in advance will save you a lot of time when you arrive for your first office visit.

Please print off each form, fill it out, and bring them all into our office at the time of your appointment.

● Adult History Form
● Medicare Secondary - Payer Questionnaire
● Pediatric History Form
● Patient Information Form
● Patient Authorization for Disclosure of Protected Health Information
● Patient Authorization for Sharing Treatment/Billing Information with Family/Friends