Destiny Family Medical Clinic

Patient Forms
 
For your convenience, we have included below all forms you will need to have filled out before your visit at Destiny. Please bring all completed paperwork with you to your appointment. If you have questions about any of these forms, please call us at 605-339-3378. We are here to serve you!
 
Patient Information

Authorization for Disclosure of Health Information

Health History Questionnaire

HIPAA Notice Of Privacy Practices