Medical Services
As a primary care provider for children, adolescents, and adults, Dr. McNiece and his staff provide medical services offering a variety of preventive care and wellness services in our role as your primary care physician.
Patient Forms
Clocktower Medical Group Opens November 4, 2024!
Patient Forms Packet
Please print and complete these forms before your appointment and fax them to our office or bring them with you to your appointment.
- Patient Forms - 18 pages
Individual Forms
If you need an individual form from the packet above, please choose form the list below.
- Patient Demographics
- Patient Intake
- Consent to Treatment and Other Acknowledgments
- Consents and Authorizations
- Consent to Obtain Prescription History
- Financial Policy
- HIPAA Authorization
- Patient Provider Relationship Agreement
Privacy Notice
Please print the following form for your records.
