Patient Forms


If you are a new patient, please complete a New Patient Medical History Form and bring with you to your first appointment.

Adult Patient Medical History Form
Child Patient Medical History Form

If you need to transfer your medical records from another medical practice to OhioHealth Primary Care Physicians, please complete the Release of Medical Records form below and give it to the medical practice that currently has your records. 

Release of Information Form


MyChart Proxy Access

If you would like another person to have access to your OhioHealth MyChart account, please complete this proxy form and bring or mail it to our office.

MyChart Proxy Form