Please print and return all applicable forms to:
Howard County Direct Primary Care
8895 Centre Park Drive, Suite E
Columbia, MD 21045
| Credit Card Authorization Form | Download Form |
| Patient/Provider E-mail Communication Authorization | Download Form |
| Physician/Patient Contract | Download Form |
| Notice of Privacy Practices | Download Form |
| Notice of Privacy Practices Acknowledgement | Download Form |
| Registration Form | Download Form |
| Patient History Form | Download Form |
| Record Release Request | Download Form |