Before You Visit

Patient Information

Our team looks forward to meeting you and discussing your healthcare needs and concerns! Prior to your appointment, we encourage you to fill out the patient forms that are provided on this page to accelerate your check-in process. Please download, print, and complete the forms and bring them with you to your appointment. 

If you are unable to download our patient forms, we recommend that you arrive to your appointment 15-30 minutes early so that you can have ample time to fill out the appropriate forms.

NEW PATIENT REGISTRATION

We are excited to welcome you to North Hills Family Medicine! 

Please print and fill out our new patient forms and bring them to your appointment.

ONLINE
BILL PAY

Log in to our Online Bill Pay system to take advantage of features like e-Statements, Statement and Payment History, and Payment Profiles.

PATIENT PORTAL

After scheduling your first appointment, we will send you a one-time Personal Identification Number (PIN) enabling you to gain access to our secure online tools to managing your health records and communicate with your doctor.

Insurance CARRIERS

We are proud to work with over 30 providers and accept a variety of insurance plans. Please call us if you do not see your carrier listed.

HEALTH EDUCATION

For your convenience, we have compiled information to help you be more informed about various health conditions and medical treatments.

PRE-VISIT QUESTIONNAIRES

Parents: You can conveniently print out and complete our pre-visit questionnaires at home and bring them to your child’s next check-up.

CONSENT FOR MINORS

Please use this form to appoint relatives, friends, teachers, clergy, neighbors – anyone who is over l8 years of age – to be responsible for your children when you are away from them.

HEALTH LOGS

We have a number of documents available for you to download and print to help you evaluate and track your health between visits.

Health Logs

Food Diary

Keeping a record of your daily food intake will help you stay on track when trying to lose weight or maintain a healthy weight.

Headache Diary

A daily headache diary is one of the most important tools your treatment team has to help you.

Medication List

Use this list to record information about all the drugs you are currently receiving and prescribed dosages.

Weight History

Please complete this form to help us formulate a weight loss plan for you.​

Depression Screening

Depression is a common & serious medical illness that negatively affects how you feel, the way you think, and how you act.

ADHD Screening

ADHD is a chronic condition marked by persistent inattention, hyperactivity, and sometimes impulsivity.

Blood Sugar Log

By recording your blood sugar readings, we can both get a better idea of how your treatment plan is working and if it should be adjusted.

Blood Pressure Log

Please use this log to record the blood pressure and heart rate (pulse) readings you take at home.

Pediatric and Adolescent Pre-visit Questionnaires

Parents: you can conveniently print out and complete these Bright Futures pre-visit questionnaires at home and bring them to your child’s next check-up.
We encourage the following well-visit schedule:

Routine Physical Reminder

If you are scheduled for a routine physical, you must come in fasting 12 hours prior to your scheduled appointment time. You may have water and black coffee ONLY! You may also take your regular medications that can be taken on an empty stomach (except diabetic medications).