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Forms and Documents

MIMA HIPAA Form

MIMA General Authorization Form

FHSAA Consent and Liability Form 2009

FHSAA Physicial Examination Form 2009     <<<<  ATTENTION: High School Athletes use this form.

High School Press Release   <<<<  ATTENTION: Click link for High School physicals schedules.


Patient History Questionnaire for an Established Patient with a New Problem

Patient History Standard Questionnaire for Patient

MIMA Patient Registration Form

Student Insurance Plan Application