Practice Documents

Documents | Forms | Patient Education

Documents can be opened in Google Chrome and completed online before printing.

CITY OF STUART FORMS

All forms relating to City of Stuart contract patients.

Cotinine-Test-Authorization

Cotinine-Test-Authorization

Pre-Employment-Physical-Stuart

Pre-Employment-Physical-Stuart

Martin County Fire Rescue Physical Checklist EW1100

Martin County Fire Rescue Physical Checklist EW1100

Police-Physical-Completion EW1100

Police-Physical-Completion EW1100

Firefighter-Physical-Completion EW1100

Firefighter-Physical-Completion EW1100

CONSENT FORMS

Employee Wellness Consent Forms

HEP-A+B-TWINRIX-Vaccine-EW1100

HEP-A+B-TWINRIX-Vaccine-EW1100

HEP-A-Vaccine-EW1100

HEP-A-Vaccine-EW1100

HEP-B-Vaccine-EW1100

HEP-B-Vaccine-EW1100

PATIENT CONSENT FORM FOR AI DICTATIONS-EW1100

PATIENT CONSENT FORM FOR AI DICTATIONS-EW1100

Consent for BIO IDENTICAL Hormone-EW1100

Consent for BIO IDENTICAL Hormone-EW1100

Consent for Prodecure EW1100

Consent for Prodecure EW1100

Employee Wellness 1100 Hormone Consent Women

Employee Wellness 1100 Hormone Consent Women

MCSO FORMS

Martin County Sheriff’s Office forms.

MCSO Pre Employment Physical

MCSO Pre Employment Physical

MCSO HRA Incentive Form

MCSO HRA Incentive Form

MCSO Medical Exam SOP143

MCSO Medical Exam SOP143

MCSOMedical Examination Completion

MCSOMedical Examination Completion

MCSO-Health-Service EW1100

MCSO-Health-Service EW1100

NEW PATIENT FORMS

These documents are available to patients on the website at tcurgentcare.com under the resources menu.

EW-1 1100 SuperBill Template

EW-1 1100 SuperBill Template

EW-2 1100 SuperBill Template

EW-2 1100 SuperBill Template

HIPAA-Privacy-EW1100

HIPAA-Privacy-EW1100

ORDERS

Orders for Imaging, etc…

Imaging Order EW1100

Imaging Order EW1100

WEIGHT MGMT

IV-Therapy-General-Release EW1100

IV-Therapy-General-Release EW1100

Prostate Protetction -EW1100

Prostate Protetction -EW1100

Recommendations and precautions using Semaglutide or Tirzepatide EW1100

Recommendations and precautions using Semaglutide or Tirzepatide EW1100

Semaglutide Dosing Instructions EW1100

Semaglutide Dosing Instructions EW1100

Semaglutide & Tirzepatide(subcutaneous) Injection Instructions EW1100

Semaglutide & Tirzepatide(subcutaneous) Injection Instructions EW1100

Tirzepatide Dosing Instructions EW1100

Tirzepatide Dosing Instructions EW1100

Weight Management Consent Semaglutide EW1101

Weight Management Consent Semaglutide EW1101

Weight Management Consent Tirzepitide EW1101

Weight Management Consent Tirzepitide EW1101

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