Patient Forms
Download and complete these forms before your appointment to save time.
Downloadable Forms
Fees & Super Billing Information
Our complete fee schedule and information about superbilling for insurance reimbursement.
DOT Physical Q&A
Common questions and answers about DOT/CDL physical examinations and requirements.
Medical Records Release Form
Authorization to release your medical records to another provider or facility.
Free Clinic Medical Release
Medical records release form for Health & Hope Mission free clinic patients.
DOT Medical Examiner’s Certificate
The official certificate provided after passing your DOT physical examination.
Patient Portal
Access your records, request refills, and message your provider.
New patients: Call (315) 323-7360 to get your portal login credentials.
Questions About Forms?
If you have questions about which forms to complete or need assistance, please call our office.
Phone: (315) 323-7360
Fax: (315) 216-3545
Rachel Raven FNP-C PLLC 