Bay Valley Medical Group is transitioning to a new computer system. With this change, every patient will need to fill out several new forms. To make sure your next appointment goes as smoothly as possible, please download and complete the Patient Conversion Form posted below and bring it with you to your appointment.
Patient Registration Conversion Form
The following forms are available on-line for your use. If you are in need of another form, please contact our customer service department at 510-785-5000 or info@bvmed.com. Our representatives are available Monday-Friday, 8:30 am – 5:30 pm and they will be happy to assist you.
BVMG Notice of Privacy Practices
History and Physical Form (download PDF)
Well-Female Exam Form (download PDF)
Well-Male Exam Form (download PDF)
Examples of additional forms available through the customer service department:
Advance Health Care Directives
DMV Disabled Placard Application
DNR Forms (Do Not Resuscitate)
EDD – Disability Forms
EDD – FMLA Forms
W.I.C. Applications
Please be advised that there may be an administrative fee for the completion of some forms by our physicians or office staff. For additional information regarding the fee schedule, please consult with customer service.
Note: The email address listed above should not be used to contact your health care provider. Questions about your care or other urgent matters should be directed to the telephone number listed above.
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