Medical Records Release (to EFH)

Allows Evergreen Family Health to obtain medical Information from another medical office or other source.

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Medical Records Release (From EFH)

Allows Evergreen Family Health to send medical information from your record to a third party such as an employer, insurance company, or other health care provider.

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Records Release (MV Accident)

Authorization for medical record release in the event of a motor vehicle accident.

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Records Release (Workers Comp)

Allows EFH to obtain medical Information in the event of Workers Compensation filing.

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Permission to discuss medical care

Allows EFH to share your medical care with family members and others of your choosing.

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Vermont Advanced Directive

Living Wills and advanced directives describe your end-of-life care. EFH advises that all adults have an advanced directive on file.

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Adult Health Database

Form for initial health exam – “Complete Physical”

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Adult Health Database Update

For follow-up or annual “PHYSICAL”

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Request an appointment

Visit the patient portal to request a date for your next appointment

Visit Patient Portal