Patient Information


Every organization has to have policies – and Evergreen is no exception. The policies (see links below) provided on this page include our General Policy, Privacy Policy, New Patient Application form, Patient Registration form, and Health History Questionnaire.

Our General Policy covers our financial policy, missed appointments, and treatment of minors. The Privacy Policy details the handling of your PHI (Patient Health Information). The Patient Application Packet must be completed, submitted and approved to become a patient at Evergreen Family Medicine. Once your Patient Application Packet has been approved, you will receive the Patient Registration form to be completed and returned.


These Policies and Forms are provided for your convenience.
  General Policy
  Privacy Practice Notification
  Patient Application Packet  
(a Patient Application Packet is required for each member of your family)