Patient Forms

Complete Forms Online

Complete and submit forms online through this portal. If you are a new patient please fill out all the forms that start with “Acacia New.” https://afmg.mymedaccess.com/public-forms

Drawing of a form

Alternatively, Print Forms

Complete and bring to appointment.

Privacy / HIPAA Policy

Please read our Privacy Policy and sign the acknowledgement below


Forms Required Upon First Visit and Annually

Update health history and registration form annually. Please provide a copy of both sides of your current insurance card or cards if you have more than one. Note: an individual is not considered a patient of Acacia Family Medical Group unless he or she has visited our office and been examined by one of our physicians or physician assistant.


New Patient Forms Required Upon First Visit - Pediatric

Update health history and registration form annually. Please provide a copy of both sides of your current insurance card or cards if you have more than one. Note: an individual is not considered a patient of Acacia Family Medical Group unless he or she has visited our office and been examined by one of our physicians or physician assistant.


Records Release


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