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.
- Patient Registration/Consent for Care and Treatment — complete this form
- Patient Financial Agreement — complete this form
- Authorization for the Release of PHI — complete this form
- HIPAA Acknowledgement & Consent — complete this form
Formas en Español
- Consentimiento General de Atención y de Tratamiento - complete este formulario
- 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 (830) 660-1722 for assistance.