Patient Forms

Fill out your New Patient Packet ahead of time and get seen faster!

If you would like to establish care, please call our office to schedule and print a copy of the New Patient Packet.

 

Complete the forms and bring them with you to your first visit, or drop them by ahead of time so we can send out for your prior records.

If you are scheduled for an Annual Wellness Visit (covered yearly for Medicare beneficiaries), please complete the Annual Wellness packet and bring to your appointment. (New patient visits and Annual Wellness visits are separate visits.

Annual Wellness Packet

4981 Indian Peak Road

PO Box 2301

Mariposa, CA 95338

Phone: (209) 682-5228

Fax: (209) 682-5227

    © 2017-2018 by Kelly A. Sharrar, M.D.