At the beginning of each calendar year, we ask that all established patients complete or update a set of the following forms. While they may seem redundant (and annoying), we have learned after 25 years that collecting accurate and verified information each year assists in providing our patients with personalized and seamless care.
For our new patients, please print out these forms and complete before your initial appointment to streamline your check-in process.
Please download and print out these forms to be completed prior to your appointment. Each year, all patients will be asked to update these forms with the [*]
- HIPAA form for 2019
- Notice of Privacy Practices Form 2019
- Consent for treatment Form 2019
- Patient Financial Responsibility Form 2019
- Patient Information Form for 2019
- Adult History Form 2019
- Records Release Form 2019
- Drug agreement Form 2019
For female patients only: