Online Forms
The following forms are for our New Patients:
New Patient Registration - Please print and fill out this registration form and bring it with you to your appointment.
Patient Medical History Form- Please print and fill out this Medical History form and bring it with you to your appointment. This will
ensure our medical staff can get your most accurate Medical History.
The following forms are here for your convince:
Request for Medical Records- Print and fill out this form if you are needing your medical records. You can bring the completed
form into our office during business hours or you can mail it.
Please Mail To: University Medical Group
Attn: Medical Records
PO Box 1610
Durant, OK 74702
Change of Insurance- Print and fill out this form if any information regarding your current information has changed. This will
help prevent any delay at your next appointment. You can bring the completed form by our office or you
can mail the form to our offices.
Please Mail To: University Medical Group
Attn: Billing
PO Box 1610
Durant, OK 74702
OSAA Physical & Consent- This form is provided for students needing an OSAA physical. Please print and fill out demographic
information and bring to your appointment.