Patient Resources

Patient Forms

If you’re a new patient, don’t forget to fill out the necessary forms before your first appointment. You can also read our office policies to learn a little more about how we operate and the ways that we support our Root Family.

Root Family Medicine Policies New Patient History Form

Health Care Proxy

to upload into patient chart once

Acupuncture Consent Form

can complete and upload prior to first appointment

IV Vitamin Infusion Consent Form

can complete and upload prior to first appointment

Botox/Dysport Consent Form

can complete and upload prior to first appointment

Medical Record Release Form

Before your First Appointment

Please read our Practice Partnership Agreement prior to your first visit. Here are a few things to consider when becoming a new patient:

We are a part of the Mass General Brigham system and are required to keep referrals within our network (except for established providers). Please ensure that you are comfortable utilizing Mass General Brigham facilities prior to joining our waitlist, especially if you live farther away from our practice location.
If you are already scheduled and your prior PCP was not in the MGB system, please request your vaccination record, and screening results (such as pap smear, colonoscopy, or mammograms) prior to your appointment date.