Skip to main content
Home: Baptist Health
Contact

Visit our COVID-19 Information Center | COVID-19 Vaccine Information

Aishah Covington Simms, MD

Aishah Covington Simms, MD

Family Physician

4.7 out of 5 stars (152)

Aishah Covington Simms, MD Office and Other Patient Information

Patient Forms

Welcome to Baptist Primary Care. To help expedite your first visit, we provide our health forms online so that you can print and complete them at your convenience. If you have any questions, please don’t hesitate to contact our office staff.

Baptist Primary Care Forms

  • Advance Directives - Designation of Health Care Surrogate Form

    This link opens the official designation of health care surrogate form provided by the Florida Agency for Health Care Administration. This form allows you to designate another individual to make treatment decisions on your behalf.

  • Advance Directives - Living Will Form

    This link opens the official living will form provided by the Florida Agency for Health Care Administration. This form allows you to document your instructions to your doctor to provide, withhold or withdraw life-prolonging procedures.

  • Advance Directives - Overview

    This link opens the official Florida Agency for Health Care Administration website. It provides detailed information about advance directives, patient's rights, frequently asked questions and forms.

  • Advance Directives - Uniform Donor Form

    This link opens the uniform donor form provided by the Florida Agency for Health Care Administration. This form allows you to indicate your desire to make an anatomical decision after death.

  • Advance Directives - Wallet Card

    This link opens the Advance Directives wallet card provided by the Florida Agency for Health Care Administration.

  • Authorization for Use of Voicemail

    Authorizes Baptist Health to leave appointment, referral and test results information on your voicemail.

  • Authorization for Use of Voicemail

    Authorizes Baptist Health to leave appointment, referral and test results information on your voicemail.

  • BPC Patient Registration and Authorization

    Captures patient demographic information, insurance information and authorizes Baptist Primary Care to prepare and submit your medical bill directly to your insurance company.

  • BPC Roosevelt Medical History & Office Policies

    Provides your primary care physician with important information about your medical and family history to better diagnose, treat or prevent conditions.

  • Medical Records Request or Release

    Initiates your request to have your medical records sent to another medical provider and/or to request your medical records from another provider be sent to your primary care doctor.