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Forms

If you require forms to be completed at times that you do not have an appointment, there is a fee associated with this service.  The patient must have been seen by an Evergreen Adult Medicine provider within the past 6 months regarding this condition.  All FMLA forms must be accompanied by an appointment and are not covered by the form fee.

New patient forms:

Please click this online form to complete a New patient appointment request.  Our office will contact you in 1-2 business days with appointment instructions.  

New Weight Management Program:

Please click this online form to request to become a weight management patient.  Our office will contact you in 1-2 business days with appointment instructions.  

Controlled Substance Agreement

Certain controlled medications prescribed by our providers are protected due to the potential dangers associated with them.  We require our patients to sign a controlled substance agreement form annually, confirming understanding of the potential risks as well as patient responsibilities accompanying these medications. As an informed patient, we require that you acknowledge both our office policies, as well as your own patient responsibility with the stewardship of any controlled substance prescription. For up to date compliance, please fully complete this online form in order to receive controlled medications from Evergreen Adult Medicine.  Lack of consent without completed form may delay prescription requests.

Medical Marijuana

We have a dedicated website for booking appointments for medical marijuana certification.  Please visit www.kindMDpa.com or click here to schedule with one of our providers.  

To learn more about registering with the state prior to the appointment, click here.

Opioid/Alcohol Abuse Treatment

We have two programs at Apple Ridge Family Medicine to help with recovery from opioid or alcohol dependency. Please complete our secure online form to get started. After we receive your online form submission, our staff will be in contact to schedule an appointment.

Suboxone Program 

Do you or a loved one struggle with addiction? We can help.

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