NEW PATIENT FORMS
Patient Forms – Primary Care, Plano, TX
Thank you for choosing Village Health Partners. We look forward to meeting you. Below, you will find new patient paperwork, organized by appointment type.
Please arrive at least 15 minutes before your scheduled appointment time and remember to bring the following:
- Your insurance card
- Your photo identification
- The completed forms (available at the end of the online registration process)
- Your immunization record (if available)
- A current list of your medications
New Patient Paperwork for Adults
New Patient Paperwork - Minor
New Patient Paperwork for Minors
Immigration Exams
Form for Immigration Exam
Medical Records Requests
Requesting and accessing a copy of your medical records is easier than ever! We partner with HealthMark Group to give you a convenient way to access your medical records.
How do I submit my request?
Please submit your requests electronically at https://requestmanager.healthmark-group.com.
- Enter your email, and login through the link sent directly to your email.
- Click on “Open New Request” from the menu options.
- Please enter your information in all required fields to provide authorization to HealthMark.
You will receive notification via email or mail once your request is processed and your medical records are available to download.
What do I do if I have questions?
Login through the same link above to view status updates or to chat with support. You can also contact HealthMark by calling (800) 659-4035 or emailing [email protected].
Endocrinology Forms
Patient Medical History
Form for Patient Medical History - Endocrinology
Review of Systems
Review of Systems - Endocrinology
Patient History
Patient History–Thyroid Visit Only
Endocrine and Metabolic
Endocrine and Metabolic Systems Review Form
Diabetes Form
If You Have Diabetes, Please Complete This Form
Glucose Readings Log
Log for Glucose Readings
Administrative Forms
Authorization for Release TO VHP
Privacy Policy
HIPAA Notice of Privacy Practices
New Patient Paperwork - Adult
New patient paperwork for adults
New Patient Paperwork - Minor
New patient paperwork for minors
Privacy Policy
HIPAA NOTICE OF PRIVACY PRACTICES
Immigration Exams
Form for Immigration Exam
Patient Medical History
Form for Patient Medical History - Endocrinology
Review of Systems
Review of Systems - Endocrinology
Telehealth Services
Consent Form
Patient History
Patient History–Thyroid Visit Only
Endocrine and Metabolic
Endocrine and Metabolic Systems Review Form
Diabetes Form
If You Have Diabetes, Please Complete This Form
Glucose Readings Log
Log for Glucose Readings
*Individual results are not guaranteed and may vary from person to person. Images may contain models.