We’ve included forms used in our practice to collect information on our patients for demographic use as well as medical information. Each form listed below is in a “PDF Fillable Format”. This format allows patients to type their information into the form while on their computer and then print them to bring to our office.

New patient forms are located below to give patients an opportunity to have most of the required forms completed before their visit.

Established patients will be asked to complete required forms and update any demographic information. All patients are required to sign a new HIPAA Consent Release form. It is the patients responsibility to update office of any changes. If patients want to transfer their care to Kristin Schmidt, MD, PLLC, they would choose the Medical Records Request below and complete that form to transfer records to our office. If patients are transferring their care from Dr. Schmidt, they would choose the Medical Records Release form below and follow the directions on the form.

To view the PDF publications available on this website, you will need Adobe® Reader® installed on your computer. Adobe Reader is available as a free download from Adobe’s website.


Get Connected

You will be added to our mailing list

[wpforms id="43" title="false" description="false"]