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Forms Available for Download
PMA TeleHealth
  Consent for TeleHealth Services  Download
New Patient Forms
  Adult Patients 18+ years  Download
  Pediatric Patients under 18 years  Download
Patient History Form
  Authorization for the Use/Disclosure of Protective Health Information Form  Download
The PMA Sleep Wellness Center
  Epworth Sleepines Scale & Patient Questionaire  Download
Gastroenterology Patient Forms
Dr. Korimilli
  Miralax Split dose Prep Colon (COLON / UPPER)  Download
  Suprep Split dose Prep Colon (COLON / UPPER)  Download
  2 Day Prep Colon (COLON / UPPER)  Download
  Upper Endoscopy Prep  Download
  Flex Sigmoid Prep  Download
Dr. Kovalovich
  Miralax Split dose Prep Colon (COLON / UPPER)  Download
  Suprep Split dose Prep Colon (COLON / UPPER)  Download
  2 Day Prep Colon (COLON / UPPER)  Download
  Upper Endoscopy Prep  Download
  Flex Sigmoid Prep  Download
Dr. Rock
  Miralax Split dose Prep Colon (COLON / UPPER)  Download
  Suprep Split dose Prep Colon (COLON / UPPER)  Download
  2 Day Prep Colon (COLON / UPPER)  Download
  Upper Endoscopy Prep  Download
  Flex Sigmoid Prep  Download
Other GI Prep Forms
  Botox Prep  Download
  Diabetic Prep  Download
  Plenvu Prep Colon Double  Download
  Single Dose Prep Colon Double  Download
  Single Dose Prep Colon Double Miralax  Download
Medicare Annual Wellness
  Health Risk Assessment  Download
Advance Care Directives
End of life care should be your decision You’ve made your own decisions your entire life. Why stop now? Make your End of Life Care wishes known and have them in writing. We’ve got the forms that you need. Talk to your Physician or Provider today!

We have partnered with Iris Plans, an independent group of healthcare experts, to speak with our patients (by phone or online video) about the importance of Advanced Care Planning. They will help you to create Advance Directives based on your preferences. These documents are shared with whomever you like, doctors, hospitals and caregivers.

If you already have an Advance Directive/Living Will, please bring it with you to your next appointment, so that we may review it with you.

You prepare for your future in so many ways, your healthcare wishes should certainly be included! Make it easier for your family and make your wishes known.
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