Notice of Privacy Practices

Effective Date October 1, 2018

THE NOTICE OF PRIVACY PRACTICES DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY. 

If you have any questions about this Notice of Privacy Practices, please contact 1-877-BMH-TIPS and choose Option 3 during regular business hours. If necessary, your question may be directed to the Privacy and Security Officer, or their designee, at the hospital, clinic, doctor’s office, or other health care entity to which your question refers. The BMG Family Physicians Group HIPAA Privacy Officer may be contacted at 901-751-5528.   You may also contact the Corporate Privacy and Security Department at Baptist Memorial Health Care Corporation, 350 N. Humphreys Blvd., Memphis, TN 38120. 

Click below to download our HIPAA Privacy Practices

VIEW THE PDF NOTICE OF PRIVACY PRACTICES FORM

NEW PATIENT FORMS

In order to save time when arriving for your first appointment, we have made available all of the standard forms that The Family Physicians Group will need to establish your medical record, and bill your insurance.

​Each patient being seen will require one copy of the following forms filled out to place in your medical record. In addition, please bring with you a copy of your latest INSURANCE CARD and a PHOTO ID for identification purposes. For parents bringing in minor children under the age of 16, we will need your photo ID and consent to treat your child.

These forms require Adobe Acrobat Reader v9.0 or equivalent application to read.