OhioHealth Primary Care Physicians

Locations in: Ashland, Lexington, Mansfield and Ontario

OhioHealth Primary Care Physicians

375 West Main Street, Lexington, Ohio 44904

Patient Forms

For your convenience, below are forms you can print and fill out before your office visit. Please present them to the front desk when you arrive. 

If you are a new patient, please complete the Patient Chart Summary Intake Form for Adults or Patient Chart Summary Intake Form for Pediatrics and bring it with you to your first visit. 

If you need to transfer your medical records to or from another medical practice to or from OhioHealth Primary Care Physicians, please complete the Authorization for Use or Disclosure of Protected Health Information (PHI) Form and give it to the medical practice that currently has your records.