Patient Forms
New Patient Paperwork
If you are a new AFOC patient, please print and complete the New Patient Paperwork. Bring it with you to your first appointment.
Release of Information Form
If you are an established patient and want to request a copy of your records or give AFOC permission to release your records to another party, please print and complete the Release of Information Form. You may submit the form in any of these ways:
- Fax it to (833) 464-5196.
- Email your completed form to medrec@afoc.com (Protecting your personal health information is important to us. Please be aware that emails may contain protected health information and are not fully secure due to the limitations of standard email systems.)
- Print the form, complete it, and drop it by one of our locations.