Welcome to Free World Medical! We are happy that you are here and hope you choose to make an appointment with us! We will work to optimize your health and well-being with the use of telemedicine. We will have a video-conference visit through the AthenaHealth platform, which is a HIPAA-secure healthcare ecosystem. We will discuss all the things you normally would at a doctor’s visit, from the comfort of your home or other private location. We will have plenty of time dedicated to get to know you and your concerns.
For easy booking for new patients, please click on the “Make An Appointment” or “Patient Portal” tab on the home page and you will be directed to the AthenaHealth portal. From there, select the link “Sign up” and create your free account with AthenaHealth and book your appointment. You will then be contacted by phone or email to obtain medical and payment information before your appointment. If you have any concerns or issues, please contact us at [email protected].
Patient Forms
Please fill out these forms prior to your visit.
- Notice of Privacy Practices
- Telemedicine Patient Consent Form
- HIPAA (Health Insurance Portability and Accountability Act) Release
The following forms are optional, please contact us to see if they are required.
- Personal Representative Request Form
- REVOCATION OF AUTHORIZATION TO USE OR DISCLOSE PROTECTED HEALTH INFORMATION
- Request for an Individual’s Health Information
- Revocation of HIPAA Authorization under HIPAA Rule 164.508
- DOL Chart Of HIPAA Notice Requirements
- Authorization for Use and Disclosure of Protected Health Information
Please note that Free World Medical does not prescribe controlled substances or narcotics, hormone replacement therapy, any form of birth control, viagra or similar drugs. We also do not order or administer vaccinations.
For a medical emergency, please go to the ER or call 911.
Free World Medical. Because it is a free world!