Thank you for choosing Harder Family Practice as your medical provider!
As a new patient, your first visit will consist of reviewing your medical history and ordering any necessary tests. We will review results with you and establish a plan to move forward.
We require all new patients to fill out a patient intake form and a medical history questionnaire on their own before their first visit. Bring these completed forms with you to your first visit. By filling out these forms ahead of time, you ensure that your first visit will be a smooth and relaxing experience.
Other Patient Forms & Information
- Agreement to Receive Medicare Chronic Care Management Services (PDF) Download
- Renewal Patient Form (PDF) Download
- Sports Physical Form (PDF) Download
- Consent to Treat Minor Form (PDF) Download
- Credit Card Policy (PDF) Download
- Disabled Parking Form (PDF) Download
- DNR- Do Not Resuscitate Directive (PDF) Download
- Living Will (PDF) Download
- ACK of Notice of Privacy Practices (PDF) Download
- Notice of Privacy Practices (PDF) Download
- Notice of Privacy Practices Receipt (PDF) Download