Associates in Internal Medicine
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Downloadable Forms

As a way to save time when you are coming to Associates in Internal Medicine, we are now providing all of our forms as downloadable pdfs. You will need Adobe Reader to view these pdf files. Download here.

Patient Information Form

Insurance Information Form

Medical History Record Form

Medication Form

Request for Records

Confidentiality Form

Privacy Policy Form and Acknowledgment of Receipt

Privacy Policy Questions and Concerns

Refill Request

Inform of Change of Info

I believe the key to being a good doctor is listening to the patient and what they have to say. They know more about their body and how it feels. I listen to what they are telling me. I also believe that I need to answer their questions. I take time to explain things thoroughly and answer all their questions.

– Goar de Lamerens, M.D.