Tanglewood Family Medical Center P.A.
Forms
New Patient Paperwork
New Patient Forms: please download and fill out the new patient forms prior to your first visit.
Medical Records Release Form.pdf
Adobe Acrobat document [534.6 KB]
Adobe Acrobat document [534.6 KB]
Release of Information to a family membe[...]
Adobe Acrobat document [218.0 KB]
Adobe Acrobat document [218.0 KB]
PatientDemographics.pdf
Adobe Acrobat document [23.9 MB]
Adobe Acrobat document [23.9 MB]
PaymentPolicy.pdf
Adobe Acrobat document [24.3 MB]
Adobe Acrobat document [24.3 MB]
For physicals and other visit forms please select the appropriate sub-pages to the left.
Please Note: It is not okay to copy and/or reproduce any form from this site for any use other than that for which it was originally intended.
Where to Find Us
Tanglewood Family Medical Center P.A.
606 N Mulberry Rd
Derby, Ks 67037
Phone: (316) 788-3787
Fax: (316) 788-2618
After Hours Physicians Exchange (316)262-6262
Clinic Hours
| Mon | 8am - 6:30pm | |
| Tues | 8am - 5:30pm | |
| Wed | 8am - 7:30pm | |
| Thurs | 8am - 4:40pm | |
| Fri | 8am - 4:30pm | |
| * Sat | 8am - 10am |
*(Acute Care only on Saturdays)
Hours may vary based on provider availability. Please call for scheduling.
Lab Hours
| Mon | 8am - 1pm | |
| Tues | 2pm - 4pm | |
| Wed | 8am - 1pm | |
| Thur | 2pm - 4pm | |
| Fri | 8am - 1pm | |
| Sat | Lab Closed |
Print 