Family Medicine, Geriatrics & Wellness
215-540-4411
New Patient Forms & Information
Thank you for choosing Family Medicine, Geriatrics & Wellness as your primary care of choice. Below you will find our New Patient Forms. We ask that you return these forms prior to your first appointment so that our trained staff can have your Electronic Medical Record ready to go for your provider of choice. You can send the forms by email, mail, fax or simply stop by during our office hours. We will be able to make your appointment once we have received your registration, health history and medical release forms.
If you are a Keystone HMO patient, please use the number 0864515001 to add us as your primary.
If you are an Aetna HMO patient, please us the number 85984 to add us as your primary.
Please note we participate we just about every insurance company, including Medicare, IBC, Aetna, United Health Care, Cigna, Bravo and Humana. We do NOT take Medicaid at this time.
NEW PATIENT FORMS
