New Patient Forms

Austin Medical Partners is welcoming patients throughout Austin, TX to join our Direct Primary Care and Concierge Care membership based clinic. If you have already signed up with our clinic, please see the important and necessary paperwork for your first appointment below. If you are curious about our comprehensive health care services, please check out our FAQ or contact our office, today!

PLEASE FILL OUT FORMS PRIOR TO YOUR SCHEDULED APPOINTMENT AND FAX BACK TO (512) 598-8699 OR EMAIL FORMS BACK. Please note email is not considered a secure form of communication.

Clicking on the forms below will automatically download them to your computer or open in your browser:

1. New Patient Enrollment & Demographics

2. Medical History Intake

3. Privacy Agreement

4. Release of Information

5. Credit Card Authorization

6. Office Policy

7. Advance Beneficiary Notice - completion required prior to enrollment and prior to performance of non-covered services

8. Functional Medicine Questionnaire - available upon enrollment

9. Men’s and Women’t Health Questionnaire - available upon enrollment

10. Direct Primary Care Membership agreement - available upon enrollment

11. Medicare Concierge Medicine Membership agreement - available upon enrollment

12. Practice Agreement - available upon enrollment

***Pricing is subject to review and adjustment per practice policy