United States Department of Veterans Affairs

Captain James A. Lovell Federal Health Care Center

Internal Medicine Forms

Commonly Used Forms

Clinic Check-in Form (TSWF form) – Facilitate checking-in for your appointment by bringing this form prefilled to your appointment.

State of Illinois Handicap Parking Placard Application – http://www.cyberdriveillinois.com/publications/pdf_publications/vsd62.pdf

State of Wisconsin Handicap Parking Placard Application – http://www.dot.state.wi.us/drivers/forms/mv2933.pdf

United States Department of Labor Family and Medical Leave Act Resources – Contains information and required forms. http://www.dol.gov/whd/fmla/ 

Pharmacy pick-up required form - Pharmacy Pick-Up Authorization Form



Lovell DoD Medical HomePort
Family Practice
Internal Medicine
Pediatrics


Internal Medicine Forms

Internal Medicine Resources