We request that all new Lapidus Cancer Institute patients print and complete the appropriate forms prior to your first appointment. Please contact us if you are unable to complete the forms or need assistance
NEW PATIENT FORMS FOR ALL SPECIALTIES
(Please complete all forms)
Patient Privacy Forms
LifeBridge Health HIPAA Notice of Privacy Practices Form
LifeBridge Health HIPAA Notice of Privacy Practices - Acknowledgment of Receipt Form
Authorization for Release of Medical Information Form
Authorization of Patient Contact Form
Advance Directive Forms
Maryland Advance Directive: Planning for Future Health Care Decisions Form
LifeBridge Health Advance Directive Form
'Did You Remember To' Instruction Sheet
Other Forms
Fall Risk Assessment
NEW PATIENT FORMS FOR INDIVIDUAL SPECIALTIES
(Complete only the forms your physician's office has indicated)
Division of Medical Oncology / Hematology (Drs. Martinez, Mery, Miller)
New Patient Health History
Division of Orthopedic Oncology (Dr. Aboulafia)
New Patient Registration Form