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Interlake Medical Center, PLLC has put its most common forms here for your convenience. Feel free to download any of these documents and prepare them in advance of your visit. You may find it more convenient to locate your insurance information and emergency contact information prior to your appointment while in the comfort of you own home.

Each of these documents is in Microsoft Word (.doc) format.

 

Authorization to disclose Health Care Information to Another Physician (0.690688 MB )

Authorization to disclose Health Care Information to Interlake Medical Center, PLLC (0.690688 MB )

HIPAA Form (0.608768 MB )

New Patient General Information Form (0.795648 MB )

New Patient Registration Form (0.029696 MB )

Notice of Privacy Practices (0.0506 MB )

Office Policies (0.032256 MB )

 

 

 
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Home Log In About Us Contact Us News Our Doctors Home Interlake Medical Center, PLLC Norman H. Leou, M.D. Jackline S. Joseph. M.D. John I. Yam, M.D. Jackline S. Joseph, M.D. Garrett P. Yam, M.D.