Patients & Forms

Patients & Forms

I’m a New Patient

When you come into our clinic for the first time we will have a few forms for you to fill out. To save yourself some time and to allow the process to flow smoother, please select the links below to complete the necessary forms. Please print and bring the form with you at your next appointment.

Infants

Birth

  • HepB: Hepatitis B vaccine. Ideally, the first dose is given within 24 hours of birth, but kids not previously immunized can get it at any age. Some low birth weight infants will get it at 1 month or when they're discharged from the hospital.

1 - 2 Months

  • HepB: Second dose should be given 1 to 2 months after the first dose.

2 Months

  • DTaP: Diphtheria, Tetanus, and Acellular Pertussis Vaccine.
  • Hib: Haemophilus Influenzae Type B Vaccine
  • IPV: Inactivated Poliovirus Vaccine
  • PVC: Pneumococcal Conjugate Vaccine
  • RV: Rotavirus Vaccine

4 Months

  • DTaP
  • Hib
  • IPV
  • PCV
  • RV

6 Months

  • DTaP
  • Hib: This third dose may be needed, depending on the brand of vaccine used in previous Hib immunizations.
  • PCV
  • RV: This third dose may be needed, depending on the brand of vaccine used in previous RV immunizations.

6 Months + Annually

  • Influenza (Flu): The flu vaccine is recommended every year for children 6 months and older:
    • Kids younger than 9 who get the flu vaccine for the first time (or who have only had one dose before July 2019) will get it in two separate doses at least a month apart.
    • Those younger than 9 who have had at least two doses of flu vaccine previously (in the same or different seasons) will only need one dose.
    • Kids older than 9 only need one dose.
  • The vaccine is given by injection with a needle or by nasal spray. 

6 - 18 Months

  • HepB
  • IPV

12 -15 Months

  • Hib
  • MMR: Measles, Mumps, and Rubella (German Measles) Vaccine
  • PCV
  • Chickenpox (varicella)

12 - 23 Months

  • HepA: Hepatitis A Vaccine; given as two shots at least 6 months apart.

15 - 18 Months

  • DTaP

 

School Age Children

4 -6 Years

  • DTaP
  • MMR
  • IPV
  • Chickenpox (Varicella)

11 - 12 Years

  • HPV: Human Papillomavirus Vaccine, given in two shots over a 6 to 12 month period. It can be given as early as age 9. For teens and young adults (ages 15-26 in girls and ages 15 - 21 in boys), it is given in three shots over 6 months. It's recommended for both girls and boys to prevent genital warts and some types of cancer.
  • Tdap: Tetanus, Diphtheria, and Pertussis Booster. Also recommended during each pregnancy a woman has.
  • Meningococcal Conjugate Vaccine: And a booster dose is recommended at age 16.

16 - 18 Years

  • Meningococcal B Vaccine (MenB): The MenB vaccine may be given to kids and teens in two or three doses, depending on the brand. Unlike the meingococcal conjugate vaccine, which is recommended, the MenB vaccine is given at the discretion of the doctor.

Medicare

What are my responsibilities as a patient?

As part of Medicare’s new model, they have developed a series of “Quality Measures” that are a combination of screening tests, immunizations, and evaluations. We are required to have you complete these to show Medicare we are taking care of you in the best way possible to help prevent you from becoming ill or having flareups of your current illnesses. As a Medicare beneficiary they are expecting you to take full advantage of these measures to do your part to help contain the ever-growing costs of caring for our aging populations.  As a patient of McGill Family Practice; we expect you to fully cooperate with the screening tests, immunizations, and evaluations.  Refusal to participate fully in these Medicare directed requirements could result in a situation where McGill Family Practice would no longer be able to provide you with medical services.  Ask us for your Medicare Passport today.

Note: Currently, MFP is no longer accepting new Medicare/Medicaid patients.  The only exceptions are current MFP patients that become of age or circumstances have dictated that they become Medicare /Medicaid patients.

Forms

When you come into our clinic for the first time we will have a few forms for you to fill out.  To save yourself some time and to allow the process to flow smoother, please select the following links to complete the necessary forms.  Please print and bring the form with you at your next appointment.”

Labs

Lab testing is often part of a routine checkup to look for changes in your health.  They also help to diagnose medical conditions, plan or evaluate treatments, and monitor diseases. So, it is very important that you come prepared for your lab to receive the best possible results.

The majority of the time we will take the lab sample here in the office and send the material out for testing at a laboratory facility. On the average we should have the results back within 24 to 36 hours.

When setting up your appointment, the doctor’s office will tell you if you need to prepare yourself for your lab visit. You may be requested to bring a sample with you, be prepared to give a sample, fast the night before.

  • Fasting – as a standard you will need to abstain from food and liquids (8 to 12 hours) the night before your appointment.
  • Providing a sample – be prepared to give a urine sample prior to coming to your appointment. During the check in process, you will be given a cup to provide the sample in.

Transferring Records

To transfer records to or from our practice, please fill out a release of records form. Please ask the front desk for the form or it can be found under "Forms" to print off and fill out. Please fax the form to 402-505-9658.