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Information to empower your healthcare

At General Physician, PC, we want you to feel comfortable and in control of your care at all times. That’s why we feel it’s important for us to provide a variety of resources to improve your patient experience and keep you informed on health and wellness.

Patient Forms

Please see below for links to conveniently download forms that are frequently used by our offices. If you have a question about whether you need to bring a particular form to your appointment, please contact your provider's office directly.

Medical Record Forms

Medical Records Requests

Access the web portal to request your medical records. Follow the directions and prompts provided. If you have any questions, please contact your provider's office.

Medical Record Amendment Form

Download the form to amend your medical record.

In accordance with the HIPAA Privacy Rule, patients have the right to request an amendment to their health records. Patients will need to complete and mail the form to the address listed at the bottom of the document. General Physician, PC will notify the patient, in writing, once GPPC receives the patient’s written request.

Patient Forms

If you’re a patient with General Physician, PC, we encourage you to log into the patient portal for the following forms:

  • Health Care Proxy
  • NY Authorization Release of Health Info

Patient Portal Login

New Patient Forms

If you’re a new patient with General Physician, PC, we encourage you to contact your provider's office and request any forms needed prior to your appointment. This will help speed up the check-in process so you can see your provider in a timely manner.

Download NYS Record Release Form

 

Breast Care Forms

Please fill out and bring the breast cancer form with you to your next appointment.

Download Breast Care Form

Gastroenterology Forms

Download PREP instructions for:

No-Fault Form

Please fill out and bring this form with you to your next appointment.

Download No-Fault Form

Women's Health Forms

Download the "Forms Completion Requisition" below. If you are requesting forms from our office, you will need to download, fill this out and return to us.

Download Forms Completion Requisition

Worker's Compensation Form

Please fill out and bring this form with you to your next appointment.

Download Worker's Compensation Form

Accepted Health Insurances

We accept most major health insurance plans available in Western New York.

  • Aetna Medicare 
  • American Health Plan of Pennsylvania
  • Blue Cross Medicaid - Amerigroup
  • BlueCross BlueShield 
  • ClaimDoc
  • EMBLEM/GHI - PPO (FEHP) and EPO lines of business ONLY
  • Empire Plan - NYSHIP (UHC Plan - No YLS Prefix) 
  • Excellus BlueCross BlueShield PPO (participate via Blue Card) *** 
  • Fidelis Care - (all LOB except long-term care) 
  • HUMANA - Commercial Plans: Choice Care PPO
  • HUMANA - MCR Advantage Plans: HMO, PPO, Private Fee for Service 
  • Humana Military 
  • Independent Health (all LOB)
  • KALOS (Gold Plan) 
  • Lifetime Benefit Solutions/RMSCO (self-funded via 3rd party network)
  • MAGNACARE (Includes Aetna) 
  • Martin's Point 
  • Medicaid Pennsylvania - SELECT PROVIDERS ONLY - Per Grid
  • Medicare
  • Medicare Railroad
  • MULTIPLAN (CIGNA) /PHCS
  • MVP (CIGNA) (NALC) Wellselect Plan
  • NOVA
  • NYS Department of Labor
  • POMCO (self-funded via 3rd party network)
  • Today's Options
  • Tricare Prime
  • Tricare Standard
  • United Healthcare
  • Univera
  • UPMC - SELECT PROVIDERS ONLY - Per Grid
  • VA ADMINISTRATION w/authorization only
  • WellCare
  • Worker's Compensation

If you have questions about your insurance, please send us a message.

Financial Hardship

If you are a patient at one of the following primary care locations, ask your provider about the sliding scale discount program.

These locations have a financial hardship application available. Buffalo - 1091 Main St., Dunkirk - 3898 Vineyard Dr.

Note: This practice serves all patients regardless of ability to pay. No one will be denied access to services due to inability to pay. There is a discounted/sliding fee schedule available based on family size and income. Call your office for more information.

Patient Education & Resources