Take Your First Steps Towards End of Life Care

We’re delighted to welcome you to our practice. To ensure we have all the necessary information to provide the best possible care, we kindly ask that you complete the new patient forms.

If you have not yet completed a consultation with Dr. Donald Moore, MD, please call us at 619-786-8222

New Patient Forms

These forms are designed to help us understand your health history, current health status, and any specific needs or concerns you may have. You will receive these forms by email from Eumoria Health.

1. New Patient Registration Form
2. Medical History Form
3. Consent to Release Information Form (HIPAA Consent Form)
4. End of Life Decision-Making Form

If you have any questions or need assistance with the forms, please don’t hesitate to contact us at 619-786-8222.

Patient Privacy and HIPAA

Safeguarding Your Privacy: Our Commitment to HIPAA

At Eumoria Health, we deeply respect and value your privacy. We understand the importance of protecting your personal health information, and we take that responsibility seriously.

In accordance with the Health Insurance Portability and Accountability Act (HIPAA), a federal law designed to safeguard your health information, we maintain stringent privacy and security practices. This means any information about your health status, the health care you receive, or the payment for such healthcare that can be linked to you is kept confidential.

Our practice follows all HIPAA guidelines to ensure your information is protected. This includes requiring your written consent before sharing any health information, using secure systems to store your information, and educating our staff about maintaining your privacy.

Rest assured, with Eumoria Health, your privacy is our priority.