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Forms and Policies

Patient Forms & Policies


Welcome to Medi-Eagle Express Healthcare! Please take a moment to review our new patient forms and policies. Before your first appointment, we request that you download and complete the required forms below and have them with you on your scheduled appointment day. This will save you the time upon arrival; however, if you are unable to complete forms in advance of your appointment, please plan to arrive 15 minutes before your scheduled appointment time to allow for this process.

New Patient Enrollment Form


If you are a new patient at Medi-Eagle Express Healthcare, download this form. Print and complete the form, and bring it with you to your first visit.

Consent to Treat Form


To ensure that the patient is fully aware and accepting of a particular treatment.

Appointment Cancellation/No Show Policy


We strive to provide excellent medical care to you and to all of our patients. Consistent with this, we have developed appointment cancellation and no-show policies that allow us to better schedule appointments for all patients.

Privacy Policy/HIPPA Form


Our Notice of Privacy Practices provides information about how we may use or disclose protected health information.

 Patient Financial Responsibility Form


Medi-Eagle Express Healthcare will file insurance claims directly to your approved insurance carrier, or assist in getting the correct information to file claims.

Covid-19 Test Intake Consent Form


Upon entering your email and date of birth, you will have the option to choose which service (COVID-19 PCR Test, Rapid Test, or Rapid PCR Test) you are scheduling your appointment for.

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