Premier Family Care Premier Family Care
  • About Us
  • Services
  • Locations
    • Broken Arrow location
    • Broken Arrow Urgent Care
    • South Tulsa location
  • Providers
    • Scott Fowler, DO
    • Clell Pond, DO
    • Kristina Price, DO
    • Patricia Iven, MHS, PA-C
    • Leisha Lawson, MSN, APRN-CNP, FNP-C
    • Brandi Shell, MSN, APRN-CNP, FNP-C
    • William Thummel, MSN, APRN-CNP, FNP-C
    • Keri Enns, APRN-CNP
    • Leticia Enriquez, APRN-CNP-C
  • Patient Forms/Insurance
  • Contact Us
  • Careers

Patient Forms/Insurance

Often it is easier to fill out patient forms in the comfort of your own home. Click on the forms below
to download them. Then just print, fill them out, and bring them to your next visit.

patient-forms

New Patient Packet – English
New Patient Packet – Spanish
Release of Information – South Tulsa Office
Release of Information – Broken Arrow Office
Drug Screening Form

Most Insurance Accepted

Premier Family Care
Patient Portal

Schedule your appointment

South Tulsa: 918-477-5190
Broken Arrow: 918-258-9990
Broken Arrow Urgent Care: 918-258-9111