ST MICHAEL MEDICAL CLINIC PA

Available Forms

1. Registration 2. Annual Wellness Questionnaire 3. Check-in, when you arrive at the clinic on the day of your appointment 4. Advance Directive - Living Will 5. Physical Information TOBACCO USER CESSATION PLAN 6. Existing patient update Demographics 7. Request an appointment

3. Check-in, when you arrive at the clinic on the day of your appointment

*** When you arrive at the clinic for your appointment, CHECK-IN by signing-in virtually to St Michael Clinic. ***

1. Birthday (MM/DD/YY) = *

2. LAST Name = *

3. First Name = *

4. Comments =

Please make sure patient confirm phone, pharmacy, and medication list.

Thank you. We will call you up to the front desk to review your pharmacy, medication list, and financial responsibility.

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NOTE: Once you are done, click submit and you should see a green messages "... successfully submitted". *** A RED messages is an error. You need to correct missing information, then click submit again. After you submit your virtual sign-in, we will call you to the reception desk. THANK YOU

* Required field