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Dopson Family Medical Center Patient Registration

Dopson Family Medical Center

You may either fill out the Patient Registration form online or print out and complete the New Patient Packet and bring it with you when you check in.

Download the New Patient Packet which includes:

  • Patient Registration Information
  • Consent
  • PHI Authorization
  • Medical Records Request
  • Notice of Information Practices

Or fill out the form below:

Step 1 of 5

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  • Date Format: MM slash DD slash YYYY