Please ensure Javascript is enabled for purposes of website accessibility Skip to content

⚠ Coronavirus (COVID-19) updates and visitation restrictions. Learn More.

Created with Sketch.
WeTreatYouLikeFamily-TM-Rev
  • Patient Portal
  • Careers
  • Home
  • For Patients
    • Patient Information
    • Accepted Insurance and Health Plans
    • Dopson Family Medical Center Patient Registration
    • Patient Forms
    • Price Estimates
      • Price Transparency
    • Patient Feedback
    • Visitation Policy
    • Notice of Nondiscrimination and Accessibility
  • Our Campus
  • Services
    • All Services
    • Ed Fraser Memorial Hospital
    • Dopson Family Medical Center
    • Baker Rural Health Clinic
    • W. Frank Wells Nursing Home
  • Find a Physician
  • Public Information
    • Health Information Links
  • Financial Assistance
    • Application Form [Online]
    • Application Form [En Español]
    • Application Form [PDF]
    • Check off Sheet [PDF]
    • Policy [En Español]
  • About Us
    • Executive Team
  • Contact
EdFraser-mobile Created with Sketch.
  • For Patients
    • Accepted Insurance and Health Plans
    • Patient Feedback
    • Dopson Family Medical Center Patient Registration
    • Patient Forms
    • Price Estimates
    • Price Transparency
    • Visitation Policy
    • Notice of Nondiscrimination and Accessibility
  • Our Campus
  • Services
    • Ed Fraser Memorial Hospital
      • Clinical Lab Services
      • Emergency Services
      • Hospital-based Outpatient Services
      • Inpatient Medical Services
      • Medical Nutrition Therapy
      • Therapies
      • Radiology
      • Respiratory Therapy
      • Surgery
    • Dopson Family Medical Center
      • Cardiology
      • Family Practice
      • Gastroenterology
      • Internal Medicine
      • Orthopedics
      • Pain Management
      • Pediatrics
      • Podiatry
      • Pulmonology and Sleep Medicine
      • Women’s Health Services
    • Baker Rural Health Clinic
    • W. Frank Wells Nursing Home
  • Find a Physician
  • Public Information
    • Health Information Links
  • About Us
    • Executive Team
  • Careers
  • Contact

Patient Forms

Patient Forms

For your convenience, many of our forms are accessible online. You may either fill out the forms online or print a paper version and bring it with you when you check in.

Ed Fraser Memorial Hospital

  • Ed Fraser Financial Assistance Application 
  • Ed Fraser Memorial Hospital Financial Assistance Check Off Sheet
  • Ed Fraser Memorial Hospital Financial Assistance Policy
  • Ed Fraser Memorial Hospital Plain Language Summary
  • Ed Fraser Memorial Hospital Plain Language Summary (En Español)
  • Nondiscrimination and Accessibility Requirements Notice 

Dopson Family Medical Center

  • Dopson Family Medical Center Patient Registration 
  • Pediatric New Patient Packet

© 2025 Baker County Medical Services, Inc.  |  159 N. 3rd Street, Macclenny, FL 32063 | (904) 259-3151

  • Site Map
  • Privacy Policy
  • Price Transparency
  • Blog
Created with Sketch.

All facilities are owned and operated by Baker County Medical Services. Website Design by BroadBased Communications.