BILL PAY     |     PATIENT PORTAL     |     EMPLOYMENT

Oakland Office

1027 Memorial Drive
Oakland, MD 21550

301-533-3300
Fax: 833-448-0361

Grantsville Office

104 Parkview Drive
Grantsville, MD 21536

844-652-8735
Fax: 833-448-0359

Mountain Laurel Medical Center

Westernport Office

22221 Westernport RD SW,
Westernport, MD 21562

240-774-0204
Fax: 833-448-0362

Bruceton Office

198 Morgantown Street, Suite 2
Bruceton Mills, WV 26525

304-379-7600
Fax: 833-448-0358

We have a provider on call 24/7 for established patients. If you need treatment for urgent, non-life-threatening conditions when the office is closed, call 301-533-3300 and press option “4” to be connected.
Translation services available upon request.

Patient Forms

New and established patients will receive a text message from Mountain Laurel Medical Center with a link to complete all required patient forms electronically. If a patient prefers to complete the forms manually, they may print them off or wait until they are in office to be provided a hard copy to complete.
i

New Patient Registration Forms

i

Release of Information

i

Privacy Policy Agreement

i

HIPAA Release Form

i

Sliding Fee Application

i

Sliding Fee Scale

i

Sports Physical Form - MD

i

Sports Physical Form - WV

i

Patient Code of Conduct

i

DOT Physical Forms

i

DOT Medical Examiner's Certificate