Action Medicine DPC Logo

781.767.0910

Forms

For transparency we try to provide forms ahead of time for our current and potential patients to read. Certain forms are needed only under certain cases.

If you are looking a form that’s not on this list please contact us for clarification.

Consent to share medical information

In order for Action Medicine to release information to a third party, our patients must consent by filling out this form:

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Terms of service

This is the terms of service that all patients agree to when signing up for Action Medicine:

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We Are Moving!

As of 12/15/2023 Our New Location Will Be:

200 Ledgewood Place, Ste 201

Rockland, MA 02370

781-767-0910

[email protected]