Forms
New Patients
As a new patient, you may choose to download, complete and bring the forms in this section with you to your first appointment. This will help expedite your visit.
- New Patient Registration
- New Patient History Information
- Notice of Privacy Practices*
- Notice of Privacy Practices Acknowledgement*
*The Privacy Practices documents can also be found in the HIPAA (Privacy) section below.
HIPAA (Privacy)
HIPAA, or the Health Insurance Portability and Accountability Act of 1996, is a Federal law that sets rules and limits on who can view and receive your health information. Please read the Notice of Privacy Practices and bring a signed copy of the Acknowledgement to your first appointment.
Authorization for Release of Medical Information
This form authorizes the release of specific medical information to other providers or individuals.
Authorization for Minors
This form authorizes medical treatment of a minor child (under 18 years of age) in the absence of parent(s) or legal guardian(s).
The documents on this page are Adobe Acrobat PDF files and require Adobe Reader. If you do not have Adobe Reader, you can download it for free.