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Holy Redeemer
HealthCare at Bensalem
3300 Tillman Drive
Bensalem, PA 19020
Get Directions

Hours

Every other Monday

8:00am – 4:00pm

Tuesday

9:00am  7:00pm

Wednesday

9:00am  8:00pm

Thursday

8:00am  4:00pm

Friday

8:00am – 4:00pm

Every other Saturday

8:00am – 12:00pm

PATIENT FORMS


Welcome to Holy Redeemer Family Medicine. In order to make your first appointment go as quickly and smoothly as possible, please print and complete the following forms and bring them to your appointment along with your insurance card, copay and a photo ID. If you’re a new patient, please arrive 15 minutes before your scheduled appointment time.

 

PDF TX-65Patient Information

 

PDF TX-65Authorization to Speak to Another Regarding Medical Care

 

PDF TX-65Consent for Financial Responsibility

 

PDF TX-65General Consent to Treatment

 

PDF TX-65Authorization for Access or Release of Protected Health Information

 

PDF TX-65Medical History - Adults

 

PDF TX-65Medical History - Ages 0-18

 

 

PDF TX-65Standing Consent To External Prescription History

 

 

Payment/copay is expected at the time of your appointment. We accept cash, check, VISA, MasterCard and Discover.


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icon-online

eCare Patient Portal



Holy Redeemer
HealthCare at Bensalem
3300 Tillman Drive
Bensalem, PA 19020
Get Directions

Hours

Every other Monday

8:00am – 4:00pm

Tuesday

9:00am  7:00pm

Wednesday

9:00am  4:00pm

Thursday

8:00am  4:00pm

Every other Friday

8:00am – 2:00pm

Every other Saturday

8:00am – 12:00pm


Holy Redeemer
Medical Office Building
1650 Huntingdon Pike,
Suite 112
Meadowbrook, PA 19046
Get Directions

Hours

Monday

8:00am – 11:00am

Tuesday

Closed

Wednesday

8:00am – 11:00am

Thursday

Closed

Every other Friday

8:00am – 2:00pm