• New Patient Forms
  • Medical Records Release Form

 

 

  • Adult Physical Forms
  • School Physical Forms
  • Medicare Health Update

 

 

 

  • Medicare Annual Wellness Benefit Visit

 

 

 

 

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

606 N Mulberry Rd

Derby, KS, 67037

 

Phone: (316)788-3787

Fax: (316)788-2618

 

Clinic Hours

Mon     7am - 4:30pm
Tues   7am - 4:30pm
Wed   7am - 4:30pm
Thurs  

7am - 6pm

Fri   8am - 3:30pm
Sat  

Closed

Lab Hours

Mon     8am - 1pm
Tues   12pm - 4pm
Wed   8am - 1pm
Thurs  

12pm - 4pm

Fri   8am - 1pm
Sat  

Closed

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© Tanglewood Family Medical Center P.A.

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