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Century Farms Family Practice

Patient Forms

We have provided preregistration forms and privacy notices to help better inform you and prepare you before your office visit.

Patient Registration Forms & Privacy Notices

If you are a new patient, please fill out the registration forms listed below in advance of your appointment to assist the staff in making sure that we have all the information necessary to provide you with quality care and treatment. Please bring the completed forms with you to your appointment.

Registration forms

Patient rights & responsibilities

We respect our patients’ dignity and pride. This document will explain your patient rights and responsibilities. It is part of your patient registration and is an important part of your health care plan.

Patient Rights & Responsibilities

Privacy notices

This privacy notice describes how health information about you may be used and disclosed and how you can get access to this information. Please review it carefully.