FORMS AND POLICIES 

 

 

 

 

 

 

 

 

 

 

 

Unless otherwise directed by your provider, maintenance medications such as Blood Pressure, Diabetes, Cholesterol and Thyroid prescriptions will be approved if the patient has had an office visit within the last three (3) months.

 

Narcotics, other controlled substances, and sleep aids will require a mandatory visit every three (3) months, unless otherwise directed by provider.

Patients requesting refill on antibiotics will need to schedule an office visit.​

 

 

 

 

 

 

If you are a new patient, please come to the Medical Records office on the Main Floor 30 minutes earlier than your scheduled appointment, so you can fill out a new patient information form.

IDENTIFICATION:
Please bring in your HEALTH INSURANCE CARD. 
In addition, you must have a Photo Identification Card. This could be your driver’s license or state-issued ID card with your photo, work ID card, or a school ID card but the card must have your photo on it.

 

MEDICATION
Please bring all your bottles of medications that you are presently taking, including over the counter medications, such as vitamins and herbal or mineral supplements.


If possible, please bring in your medical records or labs from your previous Primary Care Physician.

We want to remind our patients of the importance of having two forms of ID when visiting JFK Medical Center for scheduled or unscheduled appointments.

 

First, you MUST BRING YOUR HEALTH INSURANCE CARD.

In addition, you must have one of the following acceptable photo IDs:

  • City ID (with photo)

  • Driver's license (with photo)

  • State-issued ID card (with photo)

  • School ID (with photo)

 

Click on the name of each form to download a PDF that you can print and fill out, bringing it with you to your next appointment.

NEW PATIENT INFORMATION FORM

HIPPA PRIVACY ACKNOWLEDGEMENT FORM

AUTHORIZATION FOR RELEASE OF MEDICAL RECORDS INFORMATION

PA ADVANCED DIRECTIVE FORM

© JFK Medical Center 

3001 Walnut St. Philadelphia, PA 19104

215-386-3556

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