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New Patient? Start Here

Fill out these forms using Adobe reader and upload them below, for the most efficient way to get registered so that you can be seen in our office. If you prefer to physically fill out the documents you may do so, then email, fax, or bring them in to our front desk during office hours. Email to info@akwaabacare.com or fax to 833-989-2283

New Patient Registration Form (pdf)

Download

Medical History Form (pdf)

Download

Medical Records Release from previous practice to Akwaaba Care (pdf)

Download

HIPAA and financial/office policy (pdf)

Download

Upload your completed new patient forms

Please fill in all the fields and attach the forms below

Upload New Patient Documents
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Akwaaba Care Family Practice

1450 East Street, suite 7, Pittsfield, Massachusetts 01201, United States

office 413.728.9801 fax 833.989.2283

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If you have not yet submitted your new patient paperwork either in person or digitally, your appointment booking will be on hold until we have received it. 

Done? Book your appointment here

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