Michael Janssen, MD Office and Other Patient Information
, Jacksonville, FL 32211
- Monday 8:00 AM - 5:00 PM
- Tuesday 8:00 AM - 5:00 PM
- Wednesday 8:00 AM - 5:00 PM
- Thursday 8:00 AM - 5:00 PM
- Friday 8:00 AM - 5:00 PM
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 - 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.
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.
Health Care Authorization for Minors
Authorizes Baptist Primary Care to deliver medical services and treatment to your children.
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.
Authorizes Baptist Primary Care to make available test results and other office communication through the Medical Information Network.