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Forms & Handouts


PLEASE READ: Our forms are available for your copy and to print. For your protection—
we ask that you DO NOT email us information concerning billing or health issues.



To expedite your registration process, we recommend that you print the following forms below and bring them on the date of your visit:

  • New Patient Packet
  • HIPAA Privacy Receipt of Acknowledgement
  • Consent to Release Information
  • Office Policy - Signed


*Please have a PDF Reader installed. If not (click here) to get one.



Printable Forms

New Patient Packet

HIPAA Notice of Privacy
Authorization for Disclosure of Health Information
Patient Compact (PCMH)
Patient Consent
Office Policy


Educational Handouts

Advance Care Planning
Immunization Questions
Vaccination Schedule
for 0-8 Years

Vaccination Schedule
for Adults


FOR PATIENTS

Meet The Doctors
New Patient Packet
Insurances Accepted
Download Forms & Handouts
Log-in to My Patient Portal


Learn More »

OUR SERVICES

Preventive Care
Physical Exams
Routine Wellness Visits
Common illnesses
Minor Injuries
Immunizations
Infectious Diseases

Learn More »

REACH US ONLINE!

Take advantage of our secured web-based system via IQHealth. This allows for secured patient and office interaction when you need it most.

Call 302.855.0915



Serving the Delaware Sussex County and surrounding regions.


DC MEDICAL SERVICES
10 W. Laurel St.
Georgetown, DE
T 302.855.0915
F 302.855.0914/94

Monday-Friday:
9:00am - 6:00pm
SEAFORD INTERNAL MEDICINE
1501 Middleford Rd.
Seaford, DE
T 302.629.4569
F 302.628.4669

Monday-Friday:
8:00am - 5:30pm
SEAFORD INTERNAL MEDICINE
1507 Middleford Rd.
Seaford, DE
T 302.629.4569
F 302.536.7594

Monday-Friday:
8:30am - 5:30pm