Registration Form
Click the link below to access our registration form. Please print and complete the form, then mail or fax the completed form to our office. Our toll free fax is 866-468-9889.
If you prefer to complete the form online and email it to us directly from this website, please click on the "Registration" tab above.
Authorization Form
Click the link below to access our registration form. Please print, complete and sign the form, then mail or fax the completed form to our office. Our toll free fax is 866-468-9889.
HIPAA Notice of Privacy Practices
This Notice of Privacy Practices describes how we may use and disclose your protected health information (PHI).
Facility and Family Orientation Guide
This Guide contains a wealth of important informatioin about how to get the most out of your relationship with Doctors Making Housecalls, if you are the caregiver for a patient residing in an Assisted Living Facilities (ALFs).
We urge you to print the document, read it, and save it for future reference.
