Patient Forms

Prior to Your First Visit

Before your first visit to St. George Medical Clinic, you should review the information below and bring the proper documentation to ensure that you are properly registered for care. St. George Medical Clinic is a family practice accepting patients of all ages, whether insured or uninsured.

  • Proof of identification and insurance card
  • Proof of household income if uninsured (taxes, pay stubs)
  • Completed Patient Registration Form (below)
  • Current medication bottles or medication list

Here is a complete list of forms you will need to complete before, during, and after your appointment:

Patient Registration Form
HIPAA Release Form
Sliding Fee Application
Sliding Fee Discount Determination Form
Verbal Disclosure Form

Our Main Clinic

8591 Holly Meadows Road
Parsons, WV 26287

Phone: 304-478-3339
Fax: 304-478-3311

Patient Portal

Manage your medical information online. Click here