° Home ° Who We Are Our Services Medical Fitness Program Privacy Policies ° Appointment   Request ° Forms Medical Fitness Agreement Patient Registration Forms ° Directions ° FAQs ° Contact Us ° Newsletters Forms   Patient Information Form.  Please complete this form prior to your visit.  Please give the completed form to our registration staff upon arrival. Patient Request For Medical Records. Privacy Practices Acknowledgement.  Please complete this form and give completed form to our registration staff upon arrival.  This form provides acknowledgement that you have received our notice of privacy practices.  It also allows you to designate other individuals to have access to your health record. Request For Amendment Of Health Information.  Please complete this form to request changes to your protected health information. Authorization To Release Health Information To ProActive.  Please complete this form if we need to obtain your medical records from another physician or healthcare facility. Authorization To Release Health Information To Third Party.  Please complete this form to request the release of this form from ProActive Fitness to another party.

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