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NEW PATIENTS

           Welcome to Cole Family Practice! Below you will find the necessary paperwork to register as a new patient. We do our best to be on time as well as spend time with you during your visit. Please read the following to help us all be successful.


New patients are required to arrive 30minutes prior to your appointment with your paperwork completed. Failure to do so may result in rescheduling your appointment.

          If you need to reschedule, we require a 24 hours advance notice. 

Failure to do so may result in a $25 fee.

          If you are more than 15 minutes late for your appointment, you will have the option to wait for the next available work-in visit (the wait time will vary depending on the day’s schedule). If you do not wish to wait for the next available work-in visit, we will be happy to reschedule your appointment.

New Adult Paperwork

Pregnancy Paperwork

Release of Medical Records Authorization

Note: If scheduling more than one new child at a time, it is mandatory to turn in registration paperwork before visit. If this paperwork is not emailed, faxed, mailed, or brought in person at least 48 hours before visit, you will need to reschedule.

Pediatric Paperwork

Birth to 2 Years

Pediatric Paperwork

Three to Five Years

Pediatric Paperwork

Six to Eighteen Years

Sclerotherapy Paperwork

Please print, fill out, and bring with you to your sclerotherapy appointment the

2 following forms:

Sclerotherapy Questionnaire

Sclerotherapy Informed Consent

The following forms are informational handouts only.

Handout PRE-TREATMENT

Handout POST-TREATMENT