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23 Bustleton Pike
Feasterville, PA 19053

Hours
Mon - Wed   8:30am – 8:00pm
Thursday 10:30am – 8:00pm
Friday   7:00am – 3:30pm
Saturday    8:00am – 12:00pm*

* every 2nd/4th Saturday of each month

PATIENT FORMS


Welcome to Somerton Family Medical. As a new patient, you will be required to complete some forms before your appointment. In order to make your first appointment go as quickly and smoothly as possible, please complete all forms and bring them with you to your first appointment along with your most recent insurance card, medical records from previous physicians, list of specialists you're currently seeing, list of medications you are taking, including herbal supplements (you can also bring the medications in to review), a photo ID and your co-payment. If you’re a new patient, please arrive 15 minutes before your scheduled appointment.
 

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-65Standing Consent To External Prescription History

 

 

Patients will be billed for their services after their appointments. We accept cash, check, VISA, MasterCard, Discover and American Express.

 

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icon-online

eCare Patient Portal

Get Directions


23 Bustleton Pike
Philadelphia, PA 19053

Hours
Mon - Wed 8:30am – 8:00pm
Thursday 9:00am – 7:00pm
Friday 8:00am – 3:00pm
Saturday  8:00am – 1:00pm*

* Hours available two Saturdays per month