Due to special circumstances, until further notice Dr. Leggett is dedicating her practice, full-time, to caring for patients at Heartland Health Care & Rehabilitation Center and its sister facility, ManorCare Health Services. Therefore, we are not accepting any new home-care or ALF patients at this time.
Leggett Medical Group
No Need For "New Patient" Medical History Forms!
Transition Physician realizes how hard it is to fill out new forms!
For this reason, we do not want you to worry about filling out more medical forms! We will obtain most of your medical information from you at your initial home visit and from your medical records.
In order to obtain a copy of your medical records, all we need is some basic information and your permission to obtain your records from the hospital and/or rehab facility (or your PCP). If we have already made an appointment to see you, and you haven't already done so, please fill out the Patient Information Form and the Consent for Treatment Form and fax them to us. See the links below.
It is our goal to make things as easy as possible for you!
The only forms we will need before the Transition Physician sees you for your initial visit are the Patient Information Form and Consent for Treatment Form, which will allow us to obtain medical records from the facility you are leaving (or have left).
Print the Forms, fill them out, then fax the completed forms to (866) 894-6524
[Note: The Consent for Treatment Form above requires Adobe Reader or some other
program that will open a PDF file. If you do not have such a program,
you can download and install Adobe Reader for free by clicking on this
link: Get/Install Adobe Reader Here]
Other than filling out these two forms, YOUR job is to relax, build strength and get well!
Your Transition Physician will obtain your medical history from you personally at your initial visit, giving your Transition Physician an opportunity to really get to know you!