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Patient Forms

Adult Registration Form For adult patients, you can print this form and bring it completed to your appointment.
Child Registration Form For our younger patients, parents/guardians can print this form and bring it completed to your child's appointment.
Specialist Registration Form For patients seeing a CapitalCare specialist, you can print this form and bring it completed to your appointment.
CapitalCare Adult New Patient Packet For new adult patients, you can print this packet that contains all the required forms you need, fill it out and then bring this information with you to your first appointment.
CapitalCare Child New Patient Packet For new child patients, parents/guardians can print this packet that contains all the required forms you need, fill it out and then bring this information with you to your child's first appointment.
CapitalCare Specialist New Patient Packet For new adult patients seeing a CapitalCare specialist, you can print this packet that contains all the required forms you need, fill it out and then bring this information with you to your first appointment.
Blood Pressure Log Use this log to record your blood pressure taken at home and bring it with your to share with your doctor. You can also add this data to your FollowMyHealth patient portal account.
Blood Sugar Log Use this form to record your blood sugar and bring it with you to your appointments. You can also add this data to your FollowMyHealth patient portal account.
ROI Release Form This form gives permission for another office to send medical records to our office.
Records Release Form You can use this form to request medical records release when transferring out of CapitalCare Medical Group.
Permission to Share Form If there are family members or friends whom you would like to give us permission to share your Protected Health Information (PHI) with, please fill out this form. This form can also be used by parents and guardians for those involved in their child's care.
FollowMyHealth Patient Portal Setup Instructions If you received an invitation to join our FollowMyHealth Patient Portal and need help setting up your account, follow these set-by-step instructions.
Notice Informing Individuals About Nondiscrimination and Accessibility Requirements This notice is for your information only and does not need to be signed or returned to your office.