MacGregor Medical Center, San Antonio     9969 Fredericksburg Road     San Antonio, Texas 78240     210.690.2273

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MacGregor Medical Center of San Antonio: Patient Forms
Most of our forms can be downloaded and read using the Acrobat Reader.
Click here if you need the plug-in.

Adult History Form »
Please download this form if you are a new patient at MacGregor, or have not been in the office in the past 3 years. You can complete it at your convenience prior to your appointment.
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Children: Authorization for Medical Treatment of Minors »
If your child needs to be seen by a physician, but you or the other parent is not able to accompany the child, then you need to give written authorization for the child to be seen and treated. Please download, complete and send this with your child's caregiver.
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Children: Pediatric History Form »
Please download this form if you are bringing your child in to see one of our physicians for the first time. You can complete the history at home, then bring it with you.
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Directive to Physicians (Living Will) »
Completing a Directive to Physicians allows your physician and your family to know what you would want them to do in a case where you could not make your own decisions about your health care.
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Durable Power of Attorney for Health Care »
If you should become unable to make decisions about your health care, having this document would allow others you trust to make those decisions for you, such as your spouse, your parent, your child, your sibling or a friend. This is important if you have an accident, or develop dementia, or have a sudden debilitating illness.
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Financial Acknowledgement Form »
You will be requested to sign this form on your first visit to MacGregor.
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HIPAA - Acknowledgement Form »
The Health Insurance Portability and Accountability Act (HIPAA) requires us to provide you with the opportunity to review your rights under this act (you can look at this policy by going to the menu on the left, at the very bottom), and then to acknowledge you have had this opportunity. This is the form to say that you've had the opportunity to look at it. We are required to ask you to sign this form by the HIPAA regulations.
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Insurance Information »
Please complete Part 2 of this form before your first visit, or if your health insurance changes, so that we can more quickly get you through the check-in process.
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Medical Records Release Form - Outgoing »
Use this form to request that we send your MacGregor records to someone else. There may be a charge associated with copying records for you, but we generally do not charge for sending records to other health providers.
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Medical Records Request - Incoming »
This form allows you to request that medical information from other physicians or hospitals be sent to us. Download it, complete it, and mail it off - you may wish to make a copy for your records before mailing.
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MacGregorMed.com
9969 Fredericksburg Road
San Antonio, Texas 78240-4106
210.690.2273

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