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Waugh Chapel Family Medicine


Patient Forms

When preparing for your first visit to our office, please print and complete the following forms and bring them with you to your appointment. Please arrive 15 minutes prior to your scheduled appointment time so that we can properly register you. Also, please bring your insurance card, photo ID, and any medical records that you have with you.

Medical History Form
Click here to download

Patient Registration Form
Click here to download

Records Release Form
Click here to download

Notice of Privacy Practices
Click here to download

Authorization of Benefits
Click here to download

410-721-1507

Hours

Office Hours
Monday-Friday
7:30am-4:30pm

Waugh Chapel Family Medicine


2401 Brandermill Blvd
Suite 250
Gambrills, MD 21054

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