Patient Forms & Policies
New Patient Forms
New Patient Registration Packet - All the forms New Patients need to fill out before arriving at their first appointment.
Established Patient Forms
Patient Information Update - Update your contact or insurance information.
Authorization of Release of Information- Transfer your health records to our clinic.
HIPAA Acknowledgement - Release for HIPAA Information.
HIPAA Notice - HIPAA Privacy Act information.
Patient Policies - Information regarding Appointments, Laboratory Results, Medication Refills, Narcotics, Referrals, Returned Calls and more. All patients are required to sign.
Payment Policy - Information on Patient Payments, such as co-pays & deductibles, Insurance Payments, Appointment Cancellation fee, Billing, & Delinquent Accounts. All patients are required to sign.