Our website has a bright new look and some new features. Have fun exploring!

Forms available for EPMG members. If you have any questions regarding a form, please call Customer Service at 1-800-956-8000. All forms can be opened and downloaded in a PDF format.*

Authorization for the Use and/or Disclosure of Protected Health Information (PHI) form:

This form is used to authorize & give access to your personal health information to a family member or caregiver on your behalf.

Health Information Exchange (HIE) Forms:

Member Reimbursement:

Medicare Member Newsletter:

* Forms are available in Adobe PDF format (printer-ready.) The free Adobe Reader (for PDF format) software can be downloaded by clicking here  

Copyright © 2017 Empire Physicians Medical Group. All Rights Reserved.