About:
Forms
Living Will Information
General Forms
- New Patient Packet (PDF)
- Privacy Notice (PDF)
- Patient’s Bill of Rights (PDF)
- Consent to be Treated (PDF)
- Release of Information to PrimaryPlus (PDF)
- Release of Information from PrimaryPlus (PDF)
- Demographic Information Form (PDF)
- About the Sliding Fee Application (PDF)
- About the Slidng Fee Application – Spanish (PDF)
- Sliding Fee Application (PDF)
- Sliding Fee Application-Spanish (PDF)
- PrimaryPlus-Ripley School-Based Health Center Registration Packet & Consents (PDF)
Sports Physical Forms
PrimaryPlus also welcomes you to leave us a review on Google My Business or Facebook so we can learn more about your experience. Plus, we also WELCOME you to HONOR any of our TEAM by sending them a GIVE THANKS! Our GIVE THANKS program allows you to leave a positive message to our team which we will happily share with them. You can email Give Thanks messages to givethanks@primaryplus.net OR there are Give Thanks stations located in each of our waiting areas with cards provided where you can drop the GIVE THANKS note.