Patients

Preventive Medicine Associates is an Internal Medicine practice, adult primary care office. Our physicians care for patients 16 years of age and up. Our Nurse Practitioners care for patients 18 years of age and up.

We encourage each patient to take a preventive maintenance approach to their health so that a healthier, happier lifestyle is had by all.

Of course, we care for patients with acute and chronic disease in a thorough, appropriate, responsible, and responsive manner.

Patient Forms

Please download and complete these forms before your first visit to our office.

New Patients

Preventive Medicine Associates is accepting new patients. Please fill out the form below and someone from our office will contact you shortly.

Patient Name*:
Address*:
Phone Numbers:



Primary Insurance*:
ID number*:
Secondary Insurance:
Secondary IDnumber:

Requested Physician:
Will other members of your family also be new patients? Please enter their names and birth dates.

Current Doctor*:
Reason for leaving:
Date of your last complete physical*:

Comments:

(*) Fields Are Mandatory

Prescriptions Renewals

Preventive Medicine Associates now has the capability to send and receive new prescriptions and refills electronically to and from most pharmacies. This is the preferred method over printing and faxing to send or receive prescription requests.

From this point forward, Preventive Medicine Associated requests if you are in need of a refill, please contact your pharmacy directly whether it be your local or mail pharmacy. Your request will be received by us electronically from your pharmacy and directed to your doctor or nurse practitioner to be filled. Your doctor or nurse practitioner will then send the request back to your pharmacy for completion.

Controlled Substances:

Patients who need refills of their controlled medications will still need to call Preventive Medicine and pick up or have these refills mailed to you.

As always, please give us three (3) business days to refill your prescriptions. A fee of $5.00 may be applied if a refill is needed immediately.

Patient Resources Other Printable Forms

What should you bring to your appointment at Preventive Medicine Associates?

We want to answer as many of your questions as possible at your visit.

Please prepare for this by bringing:

  • Health Insurance Card/Information
  • A list of all medications you are taking
  • A list of your questions and concerns
  • A copy of your X-ray / CT scan reports
  • Completed New Patient Forms

Printable Forms*:

Blood Pressure Log
Blood Sugar Log

*If you cannot print out the forms, please contact us.