Marble Valley Healthworks – Central Vermont’s Concierge Medicine Practice: Seth Coombs, MD, Bruce D. Bullock, MD

A Direct Medical Practice | Marble Valley Healthworks, LLC

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p. 802.770.1805 • f. 802.773.4876
8 Commons Street • Rutland, VT 05701
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    • Seth Coombs, MD
    • Bruce D. Bullock, MD
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Forms

Below please find a list of forms you can download, print out and complete prior to coming into the office, as well as general notices and other information.

  • MVHW – Highlights and Details
  • Frequently Asked Questions
  • Patient Contact Information Form
  • Medical Information Release Form
  • Medical Records Request Authorization
  • Dartmouth Hitchcock – Patient Consent for Electronic Medical Record Access
  • Guidelines for Use of Electronic Communications
  • Join MVHW Patient Portal
  • Notice of Privacy Practices
  • Medicare Beneficiaries – Read This Before You Have Labs Drawn
  • COLST Form: https://www.healthvermont.gov/sites/default/files/documents/pdf/DNR_COLST_Instructions_Form.April%202020.pdf
  • ADVANCE DIRECTIVE Form:                                                                                                         http://vtethicsnetwork.org/wp-content/uploads/2018/12/VEN-Short-Form-Advance-Directive_Interactive_Dec-2018.pdf

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Direct and Quality Care

Monday – Thursday 8:30am – 5:00pm
Friday: 9:00am – 4:00pm

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