family first patient forms and important links

Family First is pleased to make it easy for new patients by providing health-related packets, forms, agreements and notices on-line. Just click on a link below to download (PDF) forms. You can then print and fill them out in the privacy of your home at your own pace, and bring them with you "completed" for your appointment.

Please print all forms on "white paper" only.

Also included for the convenience of our patients, are important links to other web sites.

If you have any questions or need assistance, please call (661) 341-3800 or send email.

What is thispdf logo ?

 

purple boxNew Patient Registation Form

Patient Information, Insurance Information, Assignment & Release, Physician-Patient Arbitration Agreement, Payment Policy, Authorization to Release Medical Information, Notice of Privacy Practices Acknowledgment, and Health History Questionnaire.

"New Patient Registration Form" packetdownload Orthopaedic and Podiatric Care forms packet

purple boxSports Physical

Medical Consent, Patient Information, Pre-Participation Evaluation Medical History, and Sports Physical Evaluation Results.

"Sports Physical" packetdownload Sports Physical forms packet

purple boxDMV Physical

Only originals are now accepted by the DMV, so please pick up this form in our office.

purple boxNotice of Privacy Practices

"Notice of Privacy Practices"download Notice of Privacy Practices

purple boxEDD State of California

For information regarding state disability insurance benefits, go to www.edd.ca.gov

purple boxDMV Disabled Placard or Plates Application

Form Reg195 "Disabled Placard or Plates"download Notice of Privacy Practices