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
- Authorization for the Release of PHI— complete this form
- Patient HIPAA Acknowledgment & Disclosure Consent (printable) — complete this form
- Patient Financial Agreement — complete this form
Formas en Español
- Consentimiento General de Atención y de Tratamiento— complete este formulario
- Autorización para Divulgación de PHI— complete este formulario
- HIPAA Consentimiento— complete este formulario
- Acuerdo Financiero del Paciente - complete este formulario
If you should have questions regarding the completion of these forms, please don’t hesitate to call our office for assistance.