Board Certified Internal Medicine & Rheumatology
In order to expedite your appointment, patients can download and complete their forms prior to arriving for their appointment. The forms listed below are required at each follow-up appointment. In order to open and complete these forms, Windows users must download the FREE Adobe Reader software using the link below. Patients who use Apple (Mac) computers, do not need to download the Adobe Reader DC software. Mac users can use the Preview software to download, complete and save their forms.

Download and complete these forms at home and PRINT them to bring to your doctor's appointment. There is NO SUBMIT link to electronically send these forms to our office. The latest version of Adobe Reader should allow you to save your forms to your personal computer.

Patients who decide to e-mail these forms to our office do so at their own risk. There is no protection of your confidential health information from your personal computer to our computer system. Our office will NOT be responsible for data breaches if a patient chooses to email their forms to our office.

ADOBE READER DC DOWNLOAD, Version 2015.017.20050

FREE DOWNLOAD - Use the latest version of Adobe Reader to open, complete, print, and save any form listed below. If Optional Offers are offered during the download process, please DO NOT check these boxes.

Recheck Form ("Skeleton Man")
The Recheck Form is used at each office visit and includes a joint review, review of systems, and the HAQ-DI Score. The joint review and review of systems helps Dr. Thurmond-Anderle to quickly review your chief complaint before entering the room to conduct your assessment. The HAQ-DI Score is used to quantify how well you are doing with the current prescribed treatment. Insurance companies request this information when deciding what treatment options they may cover and which they may not. Therefore, it is very important to accurately complete this information.

Medication List
A current medication list is used at each office to ensure the medications you are currently taking do not interact with any medication Dr. Thurmond-Anderle may prescribe for your arthritis conditions. Herbal medications, vitamins, and other over-the-counter medications should be included because these medications can acutally interfere with prescription medications. Therefore, it is critical that your medication list be accurate and updated for each office visit.

Our office is currently accepting new patients! Please review the information provided in the New Patient Cover Letter and complete the New Patient Medical History to schedule an appointment. Once you mail or fax the New Patient Medical History form to our office, Dr. Thurmond-Anderle will review the information provided to best determine if she can appropriately treat your medical condition. At that time, our office will call to schedule you an appointment. If you have additional questions, please feel free to contact our office at 806.379.7732 extension 210.

New Patient Cover Letter

New Patient Medical History