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Optimum Health Family Practice 2840 SW Irish Road Topeka, Kansas 66614Phone: 7852282277 Fax: 7852289892 OHFPtopeka.com Rick R. Vague, M.D., M.P.H. & T.M. Medical DirectorPATIENT CONSENT FORM I understand
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Obtain the necessary forms from Optimum Health Family Practice.
02
Fill out the personal information section, including your full name, date of birth, and contact information.
03
Provide your medical history, including any past illnesses, surgeries, or medications you are currently taking.
04
Complete the insurance information section, including the name of your insurance provider and your policy number.
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Sign and date the form, indicating that all the information provided is true and accurate.
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Return the completed form to Optimum Health Family Practice either in person or by mail.

Who needs optimum health family practice?

01
Anyone in need of primary healthcare services can benefit from Optimum Health Family Practice.
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This includes individuals of all ages, from children to senior citizens.
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Whether you have a specific medical condition that requires ongoing care or you simply need routine check-ups and preventive care, Optimum Health Family Practice can meet your healthcare needs.
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Their services extend to individuals with chronic diseases, acute illnesses, injuries, and those in need of vaccinations or screenings.
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Optimum Health Family Practice also provides women's health services, including gynecological examinations and prenatal care.
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Optimum Health Family Practice is a healthcare provider that focuses on delivering comprehensive medical care to families, emphasizing preventative medicine and holistic approaches.
Individuals and families seeking healthcare services from Optimum Health Family Practice are required to file necessary documentation and forms to enroll and receive care.
To fill out the forms for Optimum Health Family Practice, patients should provide personal information, insurance details, and medical history. Forms can typically be completed online or in-person.
The purpose of Optimum Health Family Practice is to provide holistic and preventive medical care, facilitate access to healthcare services, and promote the overall well-being of families.
Information to be reported includes personal identification details, medical history, current medications, allergies, and insurance information.
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