Patient Forms
Notice of Privacy Practices - This notice describes how medical information about you may be used and disclosed, and how you can get access to this information.
Please click on the following links. Print the forms and fill them out completely. Then bring them to our office.
New Patient Packet - Print and completely fill out these forms. Return them to our office prior to your first appointment. Please call the office (209) 599-4211 to inquire if we are accepting new patients.
The following forms are already contained in this packet:
- Patient Information Form - Print and complete this form if your information changes.
- Medical History Form - Print and complete this form to update your medical history.
- Authorized Contacts - Print and complete this form to update your authorized contacts.
Permission to treat minor - Print this form if someone other than a parent will be bringing your child to an appointment.
Medical Records
If you want to request that your medical records be transferred, you can fill out
this form and send it to the appropriate office. For assistance with medical
records, contact our office at (209) 599-4211x 110.
- Records Release - To have records sent TO our office.
- Records Release - To have records sent FROM our office.
Click here to download it.
Please call the office (209) 599-4211 to inquire if we are accepting new patients.
Your first visit to Ripon Family Physicians establishes a vital foundation for our relationship with you. During your first visit, we make sure to obtain important background information about your medical history and give you time to get to know your doctor.
Mission Statement
Our practice is working together to realize a shared vision of uncompromising excellence in medical care.
To fulfill this mission, we are committed to:
- Listening to those we are privileged to serve.
- Earn the trust and respect of patients, profession and community.
- Exceed your expectations.
- Ensure a creative, challenging and compassionate professional environment.
- Strive for continuous improvement at all levels.
What To Expect
Being well-prepared for your appointment will ensure that the doctor has all of the needed information to provide the best possible care for you. It also will help relieve any unnecessary anxiety you may be feeling. Educate yourself on your symptoms by reviewing the content on this Web site. Also, take some time to review our staff page and familiarize yourself with the doctors. We look forward to your first visit.