Download New Patient Forms

As you must know there are a number of forms you need to fill out when you first become a patient of the West Marin Medical Center. All of them are available here as PDF files. Click on the links for those you need and either use your PDF reader's print button or download a copy to your computer ("Save a Copy As") for later printing. This will save you considerable time at the clinic, allowing you to fill them out in comfort and at your convenience at home.

First, you need to fill out the Registration Form.
Next, you need to fill out the Health History Form.
Then you need to let your former doctors that it is OK
to forward your Medical Records to WMMC.

Next, you will need to sign the Financial Policy agreement which spells out what and how charges are made and responsibilities for payment.

Finally, you need to read the Notice of Privacy Practices which tells you what information will or will not be shared with what agencies under the Health Insurance Portability and Accountability Act of 1998 (usually just called HIPAA). Now you sign the HIPAA Acknowledgement stating you have read the previous document (there is a chance here to specify some restrictions but that is likely to require legal assistance).

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