Forms

Your health provider will have you fill out multiple forms prior to your first appointment.  It is very important that all of these forms are completed with accurate information.  Accurately completed forms can prevent an unnecessary error in your treatment and/or your insurance claim. 

Tips to help you fill out patient information sheets:

• Get your provider’s forms prior to your appointment.  This allows you to take your time to complete your provider’s forms.  A lot of offices and hospitals have their forms on their website or will send them to you. 
• Carefully read and answer each question.  Make sure you understand the questions you are answering.  Ask if you need more information.  The key is to ensure each question is answered accurately.
• Ensure your information readily available.   It is recommended that you have information all together in one file.  This will allow you to easily fill out information needed.
• Make copies of insurance cards and other important documents.   This way you have a copy if you lose your insurance card.  Just remember to contact your insurance company to send have them send you another card.

Complete these forms for your Files

YourMedicalBills has created informational forms for you to store your health insurance information.   Download the form you want to fill out.  Make sure you take your time to accurately complete them.   Save the completed forms in a file.   Then use the forms to assist you in completing your provider’s forms.  

Please note:  Your provider will have a separate set of  forms for you to complete.
These forms are available to assist you with keeping your important information handy.

Patient Information Form – This form includes personal information, spouse information, employer information, insurance information, and emergency contact information.

Dependent Information Form – This form allows you to keep all your dependent’s information together in one spot.

Health Insurance Information Form – This form is for your health insurance information.  It includes space to provide personal information, employer information, primary insurance information, and secondary insurance information.

Call Log - Use this form to track phone calls to your provider and/or your insurance company.  Make sure you make note of the date and time of the call and include the name of the person that spoke to you.

Medication List - Keep a list of all your medications.  This form allows you to track medications, allergies, physicians, and your pharmacy contact information.

Recommend a Form

Please contact us if you want us to add a new form that would benefit patients.