Hometown Health
Darin Charles, MD

Documents

 

New Patients

Welcome to Hometown Health! We look forward to scheduling your initial visit with us soon. Please take a few minutes to print and complete the following forms prior to your visit. If you have questions regarding these forms, please contact us.

Patient History Form

HIPAA Release Form

Medicare Patients - Please review and sign the following document

Medicare Opt-Out Understanding

Sample Contract

Membership Agreement

Fees/Services

 

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