New Patients
We’d love to welcome you as a patient!
Annapolis Family Medicine participates with most major insurance plans. There is an additional membership fee required to establish care. This fee is not covered by insurance. For patients without insurance, we offer self-pay options. If you wish to become a patient of our office, please complete ALL FIVE of the fillable forms by clicking the links below.
Membership Agreement
(Individual or Family)
If you prefer paper forms, click here for a PDF printable version.
Once we’ve received all the required forms, our office will reach out to schedule your initial appointment to officially establish care with our practice.
If you have any questions or concerns re: required forms for new patients, please call or e-mail the office at AFM@AnnapolisFamilyMedicine.org
Existing Patients
Annual Forms:
HIPAA Acknowledgement
(electronic or PDF)
AFM Payment Policy
(electronic or PDF)
Miscellaneous Forms:
Records Release Form
(electronic or PDF)
Update Insurance Card
(electronic only)
AACPS Sports Physical Form
(PDF Only)
Worker’s Comp Form
(electronic or PDF)
Medicinal Cannabis Contract
(electronic or PDF)
Controlled Substances Contract
(electronic or PDF)
Maryland MOLST Form
(PDF Only)
MVA Handicap Placard Form
(PDF Only)
