Please complete this packet prior to your first visit. NOTE: While you will describe your medical history, it is your responsibility to request that your medical records be sent by your previous doctor to CMMD & Associates. They can be mailed or faxed using the information on the Contact Us page.

Please note these forms are ONLY required for patients presenting for their Welcome to Medicare Visit (first Medicare Wellness Visit.)

This Word Document form can be downloaded and filled out on your computer, then printed and brought to the office or emailed to us.