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
- NIMA Policies and Procedures — read and sign this document
- Patient History Form — complete this form
If you should have questions regarding the completion of these forms, please don’t hesitate to call our office at (210) 650-9669 for assistance.
You are also welcome to fax these completed forms in advance of your visit. Our fax number is (210) 472-2669.