Bridge Family Practice
Home
Our Providers
Patient Portal
For Current Patients
  • Patient Forms
  • Appointment Request
  • Refill Request
  • Pay a Bill
Contact Us
Bridge Family Practice
Home
Our Providers
Patient Portal
For Current Patients
  • Patient Forms
  • Appointment Request
  • Refill Request
  • Pay a Bill
Contact Us
More
  • Home
  • Our Providers
  • Patient Portal
  • For Current Patients
    • Patient Forms
    • Appointment Request
    • Refill Request
    • Pay a Bill
  • Contact Us
  • Home
  • Our Providers
  • Patient Portal
  • For Current Patients
    • Patient Forms
    • Appointment Request
    • Refill Request
    • Pay a Bill
  • Contact Us

Patient Resources

Medical Records Release

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Blood Pressure Log Submission

Submit

Authorization to Disclose PHI

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Patient Info Update

Update

Update Insurance Information

Update

Patient Feedback

Submit

Patient Consents

Annual Consents

Complete

Controlled Substance Agreement

Complete

Testosterone Treatment Consent

Complete

Procedure Consent

Complete

Various Policies

Outstanding Balance Policy (pdf)Download
Medicare Coverage Policy (pdf)Download
Age Eligibility Policy (pdf)Download
Insurance Claim Denials, Resubmission, and Non‑Covered Services Policy (pdf)Download
Insurance Verification & Coverage Responsibility Policy (pdf)Download
Laboratory Services, Billing, and Coding Integrity Policy (pdf)Download

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Online Bill Pay Is Now Here!

For your convenience, patients can now pay any outstanding balance, anytime through our secure online portal. 

It’s quick, easy, and available 24/7. 

Click Here to Pay

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