Skip Navigation

Physician Toolkit for PCMH

This toolkit provides sample materials to help you inform your patients about and engage them in your patient-centered medical home. Feel free to customize each document to fit the needs of your practice. (You are not required to use these materials and should be sure they reflect your practice before using them.)

Pre-Visit Contact Form
Questions your staff can ask a patient to help you prepare for their visit.

Introductory Letter to Patient, with Rights and Responsibilities
Announce your patient-centered medical home approach to your patient and describe how they will participate in a patient-centered medical home.

Patient-Provider Partnership Agreement
A "best practice" used in many patient-centered medical homes, this agreement is signed by your patient to indicate an understanding of and agreement to participate in a patient-centered medical home.

Patient Checklists
Help your patient prepare for their first and future appointments with you under the patient-centered medical home.

Information for Families Brochure
A patient-centered medical home deals with the whole patient. Help your patient's family maximize the benefits of the patient-centered medical home.

Your Patient-Centered Medical Home Brochure
Patient-centered means you will be surrounded by a dedicated team of health professionals working together to meet all of your individual health care needs.