Explains how your medical information may be used and disclosed, as well as how you can get access to this information.

Fillable and printable PDF that you can complete and either send to us or submit yourself to the medical records department of your previous providers. MUST BE SIGNED BY YOU, either electronically or by hand.

A simple document explaining Direct Primary Care and how it works at GRFW

This is just a SAMPLE. You will be asked to complete an official agreement if you decide to start a membership subscription. No agreement is needed for the initial consult or for stand-alone visits.