Patients > Patient Forms
For patient convenience new patients are able to download the necessary forms to fill out before your appointment. This will save you time when checking in.
Adair County Medical Forms
Adair County Medical Clinic New Patient Forms
Worker's Compensation Form
Automobile Accident Form
Consent Form
Sports Physical
Release of Information
HIPPA
Handicap Plates
1st Five Well Child Forms
9 Month Questionnaire
18 Month Questionnaire
24 Month Questionnaire
30 Month Questionnaire
Employer Form
Client Authorization for Treatment
Adair County Specialty Clinic Forms
Urology New Patient Form - Zafar
Podiatry New Patient Form - Neustrom
Cardiopulmonary Rehab Forms
C.A.R.E. + Program:
Patient Information Form
Medical Clearance Form
Informed Consent Form
Pulmonary Rehab:
Patient Education Assessment Form
Cardiac Rehab:
Patient Edcuation Assess Form
Flu Vaccine Form
Flu Vaccination Form
Privacy Act
Adair County Medical Forms
Adair County Medical Clinic New Patient Forms
Worker's Compensation Form
Automobile Accident Form
Consent Form
Sports Physical
Release of Information
HIPPA
Handicap Plates
1st Five Well Child Forms
9 Month Questionnaire
18 Month Questionnaire
24 Month Questionnaire
30 Month Questionnaire
Employer Form
Client Authorization for Treatment
Adair County Specialty Clinic Forms
Urology New Patient Form - Zafar
Podiatry New Patient Form - Neustrom
Cardiopulmonary Rehab Forms
C.A.R.E. + Program:
Patient Information Form
Medical Clearance Form
Informed Consent Form
Pulmonary Rehab:
Patient Education Assessment Form
Cardiac Rehab:
Patient Edcuation Assess Form
Flu Vaccine Form
Flu Vaccination Form
Privacy Act