For your convenience, we have included the patient forms that need to be read and/or completed at the time of your first visit. Please print the forms, fill them in and bring the completed forms with you to your first visit.
- Patient Registration/Consent for Care and Treatment — complete this form
- Patient Financial Agreement — complete this form
- Request for Medical Records
- HIPAA Acknowledgement & Consent — complete this form
Formas en Español
- Acuerdo Financiero del Paciente - complete este formulario
- Autorización para Divulgación de PHI - complete este formulario
- HIPAA Consentimiento - complete este formulario
If you should have questions regarding the completion of these forms, please don’t hesitate to call our office at (210) 614-5400 for assistance.
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