Lehighton Family Medicine
New Patient Medical History and Questionnaire - your medical history, allergies and more.
Your input here will help us to treat you and to understand your current state of health.

Release of Medical Records - use this form to have your medical records transferred to
Lehighton Family Medicine. Complete the form and we will contact your previous provider for
you to ask for copies of your medical records.

Notice of Privacy Practices (HIPPA) - we are required by law to maintain the privacy of your
personal health information and provide you with notice of our legal duties and privacy
practices.

Acknowledgement of Privacy Practices - you are required to acknowledge receipt of the
above-mentioned
Notice of Privacy Practices.

Financial Policy - so there are not surprises later, you are required to read and acknowledge
the Lehighton Family Medicine Financial Policy

YOU MAY DOWNLOAD ALL FORMS HERE




All above pdf forms require Adobe Reader.  



We will arrange
to have your
medical records
transferred
to our office


We ask that you
please read our
Financial Policy
Kenneth Sharp, DO
Board Certified Family Medicine
Other Downloads

Instructions for Life
A few words of wisdom
from the Dalai Lama that
we should all take to heart.
You will find this hanging
in our waiting room.

Desiderata
This very old, but 'healthy'
document (dated 1692)
was found in Old St Paul's
Church in Baltimore.

9 Principles, 12 Values
Political parties and
issues set aside, these
are sound principles
and values that all
Americans should
subscribe to.