The following documents are used regularly by Pisgah Family Health. These are available to speed up your next visit to our office. Print the appropriate forms, complete them by hand, and bring the papers to your visit. Please do not attempt to Email these to us, as we cannot guarantee the privacy of Email.

These forms are in PDF format and require Adobe Acrobat. If you do not have Adobe Acrobat you may Download it Here.

Adult - New Patient Forms

Patient ID and Insurance Adult Medical History Health Screening Checklist	These forms should be completed before your first visit to our office.
HIPAA Privacy	How we protect the privacy of your medical information.
Request for Records	To allow us to obtain your medical records from another provider.
Practice Info	Information about our practice and services we offer.

Child - New Patient Forms

Patient ID and Insurance Child Medical History Minor Child Medical Release	These forms should be completed before your child's first visit to our office.
HIPAA Privacy	How we protect the privacy of your child's medical information.
Request for Records	To allow us to obtain your child's medical records.
Practice Info	Information about our practice and services we offer.

Adult - Physical Exam Forms

Adult Medical History Health Screening Checklist	Complete these prior to your physical, to keep your chart up-to-date.
Men's Health Women's Health	Health maintenance recommendations for men and women by age.
FMLA form	Family Medical Leave Act - when an illness keeps you out of work >3 days.
CDL Exam	For a DOT Commercial Drivers license.
Temporary Placard Permanent Placard Permanent Plate	To apply for a DOT handicap placard.

Child - Physical Exam Forms

Request for Records	We review vaccinations at every child physical. Please bring your vaccination record.
Buncombe County Asheville City NC Sports Exam	Forms used by local schools for sports participation.
NC Kindergarten Exam	This must be completed prior to kindergarten enrollment.

Flu Shot Consent Form

The season for Flu shots is September through February. We recommend everyone over 6 months of age get their shot. To speed up your visit, you can pre-print and complete the consent form HERE.

Health Care Directives

POA Forms- NC Health Care Power of Attorney
Advance Directive- NC Advance Directives - also called Living Wills