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Patient Info
Patient Info
Welcome to the patient information section of our website. We have collected several resources here that you may find useful. Clearwater Family Medicine is proud to be a Patient-Centered Medical Home and we provide this service to all our patients as part of our mission of providing quality care. We also have up-to-date information on insurance and billing questions, as well as links to the required forms for new patients.
Patient Forms
All new patients are asked to complete registration and history forms prior to their first visit.
All patients
Registration Form
Records Release
New Adult Patient Questionnaire
Lifestyle Questionnaire
Delegation Form
Cancellation
Wellness Letter
Medicare Health Risk Assessment
Pediatrics
Ages & Stages Questionnaire – 4 months
Ages & Stages Questionnaire – 6 months
Ages & Stages Questionnaire – 8 months
Ages & Stages Questionnaire – 9 months
Ages & Stages Questionnaire – 10 months
Ages & Stages Questionnaire – 12 months
Ages & Stages Questionnaire – 14 months
Ages & Stages Questionnaire – 16 months
Ages & Stages Questionnaire – 18 months
Ages & Stages Questionnaire – 20 months
Ages & Stages Questionnaire – 22 months
Ages & Stages Questionnaire – 24 months
Ages & Stages Questionnaire – 27 months
Ages & Stages Questionnaire – 30 months
Ages & Stages Questionnaire – 33 months
Ages & Stages Questionnaire – 36 months
Ages & Stages Questionnaire – 42 months
Ages & Stages Questionnaire – 48 months
Ages & Stages Questionnaire – 54 months
Ages & Stages Questionnaire – 60 months
PCMH
The Patient-Centered Medical Home (PCMH) is an approach to providing comprehensive care for children and adults, in a health care setting that facilitates partnerships between patients and their primary care physicians.
Insurance & Billing
We accept most major insurance plans. Please remember, it is impossible for Clearwater Family Medicine to know every insurance plan. We do our best to know what plans are accepted but ultimately it is up to the patient to know their insurance. Click Learn More for more information.
Medical Links
The amount of “health” information available via the internet is overwhelming and some of it can be less than reliable. Our medical links section contains valuable information from quality sources. Click “Learn More” below to see our Medical Links section.
