Patients

We are always glad to welcome new patients to our practice. If your first visit is scheduled, you can download these required forms below and complete them to save you time during your visit to our office.

All forms can be printed directly from your computer.

Patient Information/Updated Health History Form: General Patient Information (Name, Address, DOB, Insurance, etc) and Health History about you or the individual(s) that our office is seeing.

Insurance Benefits, Medical Information Release & Financial Responsibility Agreement: Explains what the patient is responsible for regarding insurance (if applicable), that medical records of a patient can be shared and financial responsibility of the patient.

Notice of Privacy Practices: This notice describes how health information about a patient may be used and disclosed and how a patient can get access to this information.

HIPAA Acknowledgement: This form states that the patient has read and received a copy of the office’s Notice of Privacy Practice

Cancellation Policy : To ensure all patients are seen at their scheduled time please provide 24 hours notice if you need to cancel or change your appointment otherwise a charge can be assessed to your account. Please print, sign and bring with you to your visit.