151 Parkview Drive • Millersburg, Ohio 44654 • p.330.674.1200 • f.330.674.3320

Holmes Family Medicine
  • Robert A. Hart, M.D.
  • Scott F. Brown, M.D.
  • John A. Vaccariello, M.D.
  • Laura E. Barr, M.D.
  • Kimberly Hills, PA-C

Click on any of the providers listed above to learn more about them both personally and professionally.

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Downloads & Forms

Documents with an asterisk (*) require a password to open. Please call our office and speak with the Scheduler or Medical Records Department for this password.

  • New Insurance Patient Packet*
  • New Self-Pay Patient Packet*
  • Medication Dosages for Children
  • Form to Transfer Records to HFM*
  • Form to Transfer Records out of HFM to Other Providers
  • Medical History Form*
  • Patient Information Form*
  • Payment Policy for Patients with Insurance*
  • Payment Policy for Self-Pay Patients*
  • Over-the-Counter Medications During Pregnancy
  • Notice of Privacy Practices
  • Notice of Privacy Practices Acknowledgement*