Plumtree Family Health Center

Specialist in Family Practice

Patient Documents

For NEW Patients; Please complete all forms prior to visit.

Patient Info Packet- Updated 10/10/14- Applies to new and current patients

Patient Registration Form

Financial Agreement

Protected Health Information Release

Patient History Form

Release to release records TO Plumtree from another provider

This form should be used if you are sending your child to a visit at our office and you will not be present.

Consent to Treat Minor

Please complete the form below to allow Plumtree to release your medical records. Please note there is a charge for medical records and this fee must be paid prior to records being mailed or faxed.

Record Release from Plumtree

Please click on the following link to open the instructions to log on to WEBVIEW.

Webview Login Instructions

104 Plumtree Road, Suite 102 Bel Air MD 21015 Phone: 410-569-4224 Fax: 410-569-4368