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Forms

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 FormDownload Form
Patient/Provider E-mail Communication AuthorizationDownload Form
Physician/Patient ContractDownload Form
Notice of Privacy PracticesDownload Form
Notice of Privacy Practices AcknowledgementDownload Forms
Registration FormDownload Form
Patient History FormDownload Form
Record Release RequestDownload Form
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