Patient Forms

Welcome to Columbus Adult Medicine!

We are pleased that you have entrusted us with your healthcare. It is a privilege we take very seriously. Our goal is to provide outstanding care to achieve the highest possible patient satisfaction. As we are always looking for ways to improve our service, please feel free to comment on any issues that are of concern. We feel that we have a talented and dedicated staff. They will address any questions you may have regarding your healthcare.

If you are unable to keep your scheduled appointment, kindly call the office at least 24 hours in advance. New patients who fail to show or cancel within 24 hours of their appointment, will be subjected to a $50 charge on their account. This fee must be paid before scheduling a future appointment. Established patients will be assessed a $25 charge for similar reasons.

We are proud of our staff and our office. We hope you share our sentiments.

Thank you for joining us.

For your first visit to our practice, download and print the information packet below. Fill out the information, and bring with you to your first appoinment.

New Patient Packet

Returning Patient Packet

BARIATRIC Patient Packet

Consent to Share Health Information Form

Protected Health Information (PHI) Disclosure

If you have questions about any of the forms, we'll be happy to assist you when you visit our office.