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eCare Patient Portal



1844 Street Road, Suite 2
Southampton, PA 18966
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Hours
Monday 9:00am – 7:00pm
Tues/Thurs 9:00am – 6:00pm
Wednesday 9:00am – 3:00pm
Friday 9:00am – 5:00pm


201 Veterans Way
Warminster, PA 18974
Get Directions

Hours
Monday 9:00am – 7:00pm
Tues/Thurs 9:00am – 6:00pm
Wednesday 9:00am – 3:00pm
Friday 9:00am – 5:00pm

PATIENT FORMS


Welcome to Flanagan Family Medicine. As a new patient, you will be required to complete some forms before your appointment. In order to make your first appointment go as quickly and smoothly as possible, please complete all forms and mail, fax or bring them with you to your first appointment along with your most recent insurance card, medical records from previous physician, list of specialists you’re currently seeing, list of medications you are taking, including herbal supplements (you can also bring the medications in to review), a photo ID and your co-payment. If you're a new patient, please arrive 20 minutes before your scheduled appointment.

We accept cash, check, VISA, MasterCard, Discover and American Express.
 

PDF TX-65Patient Information

 

PDF TX-65Authorization to Speak to Another Regarding Medical Care

 

PDF TX-65Consent for Financial Responsibility

 

PDF TX-65General Consent to Treatment

 

PDF TX-65Authorization for Access or Release of Protected Health Information

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icon-online

eCare Patient Portal

Get Directions


1844 Street Road, Suite 2
Southampton, PA 18966

Hours
Monday 9:00am – 7:00pm
Tues/Thurs 9:00am – 6:00pm
Wednesday 9:00am – 3:00pm
Friday 9:00am – 5:00pm