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PATIENT REGISTRATION

Prior to your first appointment, please download, read and complete the following forms.  (Click each title to download a copy in a PDF format).

            Patient History Form, Part 1 

            Patient History Form, Part 2

            Patient Registration Form

            Patient Questionnaire Form

            H.I.P.A.A. Policy Statement

 

Please review the HIPAA Policy Statement and indicate that you have reviewed it by placing your initials on the Patient Registration Form.

 

RECORDS RELEASE

To obtain your old records, you need to download and submit a Medical Records Release Form to your previous physician.

Download this form by clicking the following link:

            Medical Records Release



 

DISCLAIMER

Internal Medicine/Richard A. Gobao, MD, LLC contains articles on many medical topics; however, no warranty whatsoever is made that any of the articles are accurate. There is absolutely no assurance that any statement contained or cited in an article touching on medical matters is true, correct, precise, or up-to-date. The overwhelming majority of such articles are written, in part or in whole, by nonprofessionals. Even if a statement made about medicine is accurate, it may not apply to you or your symptoms.

The medical information provided on our website is, at best, of a general nature and cannot substitute for the advice of a medical professional (for instance, a qualified doctor/physician, nurse, pharmacist/chemist, and so on). Our website IM/RAG is not a doctor.

None of the individual contributors, system operators, developers, sponsors of our website nor anyone else connected to our website can take any responsibility for the results or consequences of any attempt to use or adopt any of the information presented on this web site.

Nothing on RAGDOC.COM or included as part of any project of INTERNAL MEDICINE/RICHARD A. GOBAO, MD, LLC., should be construed as an attempt to offer or render a medical opinion or otherwise engage in the practice of medicine online.