Before You Get Started
You must, without exception, complete all new patient forms and consents- see “Forms” tab above..
Please provide us with the following documents if you have them
Living Will
POLST
Do Not Resuscitate
Health Care Surrogate
Health Care Power of Attorney
Five Wishes
Ways to Complete
Digitally
Complete online
Complete all forms
Submit
Complete on your electronic device and email
Go to Form Downloads
Download forms
Fill out forms
Save changes
Email completed forms to pchc34@mdofficemail.com
Physically
Go to Form Downloads
Download forms
Print & complete forms
Email completed forms to pchc34@mdofficemail.com or fax completed forms to 850 934 0379