Welcome to Alliance Internal Medicine, we are pleased to serve your health care needs. Below are forms that you may need to review or complete prior to coming in for your appointment. Please call us if you have questions. Privacy Notice This document explains your privacy rights as a patient. You will be asked to sign a copy in the office to indicate you've read it. Disclosure Please use this form to let us know names of friends or family that we can speak to regarding your health information, as well as where we can leave messages for you. Health Care Proxy If you do not have a designated Health Care Proxy, please review this and complete it. This designates an individual who can speak for you, and make health care decisions, in the case you are too ill to speak for yourself. We recommend this for everyone, and suggest you make copies and give it to your proxy(ies). Record Request Please use this form to request records from your previous doctor(s) to be sent to us. In order to get records you must sign the form, and fax or mail it to their office. Patient Registration Please complete this form prior to your first appointment. Enter as much information as possible to make sure we have the key components of your medical information for this initial appointment.