New Patient Registration



If you are a new patient, please complete this New Patient Registration Form and bring it with you to your first visit.

If you are a new patient, please also complete a new patient medical history form:
New Patient Medical History Form for Adults
New Patient Medical History Form for Children

If you need to transfer your medical records from another medical practice to OhioHealth Primary Care Physicians, please complete the Release of Medical Records form below and give it to the medical practice that currently has your records. 

Release of Information form

 
If you would like another person to have access to your OhioHealth MyChart account, please complete this proxy form and bring or mail it to our office.
 
 

For any questions please don’t hesitate to contact us, we would be happy to help you. Feel free to call us at (614) 533.6890 or (740) 654.4942.