LCM
Medical Institute

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Forms
 

To make it easy for you to access the forms you need, we have placed commonly used forms on the website for you to access. Simply print the appropriate form,  complete and bring to your visit with the doctor.

The forms are available in Adobe Acrobat PDF format for offline reading or printing. If you do not already have a copy of Adobe’s Acrobat Reader™, you may download a copy from their site.

  Welcome New Patients and Families

  Advance Directive - English

  Advance Directive - Spanish

  Eligibility Waiver

  Comprehensive Health Questionnaire - Long Form

  Health Questionnaire - Short Form

  HIPPA Consent for Treatment

  Non Payable Financial Waiver

  Notice of Privacy Practices - English

  Notice of Privacy Practices - Spanish

 
 

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