If you are not sure which forms you need to fill out, call (800) 258-4448 to ask an appointment representative. For some types of visits, such as a pregnancy test or HIV test, you will fill out paperwork when you get to the Health Center. Some types of forms will still need to be completed at your visit, such as a consent form.
For women -
If you have never been to PPLM before - and your appointment is for:
- An annual exam >> Fill out these forms
- A follow-up exam >> Fill out these forms
- STD test (other than HIV) >> Fill out these forms
- If you are having symptoms >> Fill out these forms
- Birth control (without an annual exam) >> Fill out these forms
For men -
- For all appointments >> Fill out these forms
For All PPLM Patients -
If you would like to transfer or obtain your medical records, you need to sign a release if you would like:
- To send your medical records to another provider >> Fill out this form
- A copy of your medical records sent directly to you >> Fill out this form
There is a fee required if sending the medical records directly to you:
- $10 - For medical records less than 2 years old.
- $30 - For medical records more than 2 years old.
Please allow up to 10 business days to process your request. If you have any questions, please contact our health center.
