Magan Medical Clinic, Inc.

Patient Resources

Please print and fill out the forms below that correspond with your appointment.

New Patient Packet English(click to download)

New Patient Packet Spanish(click to download)

This packet includes the following forms listed below:

  • Patient Registration I
  • Patient Registration II
  • Eligibility Waiver Form
  • Notice of Privacy Practices
  • HIPPA Summary of Notice of Privacy Practices and Acknowledgement Form
  • Permission to Discuss Personal Health Information with Other Individuals
  • Advance Healthcare Directive Acknowledgement

Adult Medicine

Pediatrics

Specialty Care

  • Coming soon

GYN

  • Coming soon

Mammography

  • Coming soon

Patient Information Release Forms

  • Patient Information Release Forms Authorization for Use or Disclosure of Protected Health Information (click to download)