Online Forms
Download and complete these forms before your visit to save time and ensure we have all the information we need.
How It Works
Three simple steps to complete your forms
Download Forms
Click on any form below to download a PDF version to your computer.
Print & Complete
Print the form and fill it out completely using black or blue ink.
Bring to Appointment
Bring completed forms to your next appointment, or fax/mail them in advance.
New Patient Forms
Forms required for your first visit to The Nephrology Group.
Patient Information Form
PopularComplete patient demographics and contact information.
Medical History Questionnaire
PopularComprehensive health history form.
Insurance Information
Insurance and billing details.
HIPAA Consent Form
Privacy practices acknowledgment.
Medical Records
Request copies of your medical records.
Medical Records Release
Authorization to release medical records.
Records Transfer Request
Request records from another provider.
Consent Forms
Treatment and procedure consent documents.
General Consent for Treatment
Standard treatment consent form.
Dialysis Consent Form
Consent for dialysis treatment.
Procedure Consent
Consent for specific procedures.
Administrative Forms
Other administrative paperwork.
Patient Survey
Help us improve our services with your feedback.
Appointment Cancellation
Cancel or reschedule an appointment.
Address Change Form
Update your contact information.
Insurance Update Form
Update your insurance information.
For Healthcare Providers
Referral forms for physicians and healthcare professionals
New Patient Referral Form
Refer a patient to The Nephrology Group for kidney care services.
AvailableSubmitting Your Forms
Completed forms can be submitted in the following ways:
In Person
Bring to your appointment
Fax
(559) 228-6601
1630 E. Shaw Ave, Suite 105, Fresno, CA 93710
Need Help?
If you have questions about which forms to complete or need assistance, our staff is happy to help.
Call us at
1-559-228-6600
Office Hours
Mon - Fri: 8:00 AM - 5:00 PM
Access Your Patient Portal
Log in to your patient portal to view test results, request prescription refills, and communicate with your care team.
Go to Patient Portal