        |
Online Forms
Registration Form
Click here to download the registration form PDF file
Print this form and complete it if you have an upcoming appointment and:
1. will be a new patient to Doran Clinic;
2. have not been seen at Doran Clinic for 3 years; or
3. have had any insurance changes.
***Bring the completed form to your appointment along with your insurance card.***
Release of Information
Click here to download the release of information form PDF file
In order to obtain a copy of your medical records or have them sent to another physician or facility, you must complete the release of information in its entirety, sign it, and date it. The boxed section is only required if the specific information listed needs to be released and is applicable in your situation.
After you complete the form, you can:
1. bring the form to the clinic;
2. fax the form to 515-239-6950; or
3. mail the form to: Doran Clinic, ATTN: Medical Records Department, 1015 Duff Avenue, Ames, IA 50010
Please allow 7-10 days for processing.
It is important to list a telephone number where you can be contacted during the day in the event we would have any questions.
|
