New patients at Greater Portland Health (GPH) are required to complete the following forms in order to become a patient. Please have personal information such as name, date of birth, social security number, as well as health insurance information, household income, and emergency contact ready before completing the registration. 

New Patient Registration Forms

Please bring completed New Patient Registration Forms with you to your first appointment. 

Consent to Treatment Form

Release of Information (ROI)

Fully completed and signed ROI forms may be faxed to the Medical Records Department at 207-761-3829 attn.: April C. 

Please note that all applicable fields must be completed for this ROI form to be considered valid, accepted, and processed.

Per Maine Law GPH Medical Records Department has 30 days to process the ROI request.

Medical Records Requests

We are happy to share our newest partnership with ScanSTAT Technologies. On 02/09/2023 their team started to process Release of Information/Medical Records Requests for all GPH locations.

Click HERE to request your medical records online.

Click below to learn more about medical record requests.

Notice Of Privacy Practices