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Lofts Medical Associates
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Forms

Click the links below to download forms:

HIPAA Medical Record Release Form

Medical History Form

New Patient Registration

Record Release Form

General Consent to Treat

Financial Responsibility Form

A tablet with a medical history form on a blue background. Medical diagnosis of a doctor's prescription.

Logo for Lofts Medical Associates. The initials "LMA" are in large blue letters, with a green swoosh looping around the "M." The full name appears in blue, stacked to the right of the initials.

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About
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Hours

Mon: 9:00 am – 5:00 pm
Tue: 9:00 am – 6:00 pm
Wed: 9:00 am – 6:00 pm
Thu: 9:00 am – 6:00 pm
Fri: 9:00 am – 4:00 pm
Sat – Sun: Closed

Contact

(215) 757-8100

contact@loftsmedical.com

170 Middletown Blvd #101
Langhorne, PA 19047

© 2026 Lofts Medical Associates. All Rights Reserved.