Patient Forms & Policies

Patient Forms

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. 

Patient Policies - Information regarding appointments, medication refills, lab results, referrals, and more.

Payment Policy - Information on patient payments, such as co-pays & deductibles, insurance payments, & billing.

HIPAA Acknowledgement - Release for HIPAA Information.

HIPAA Notice  - HIPAA Privacy Act information.


Insurance Information

 

 Please check with your health insurance company for a list of Participating Providers for your specific plan.


All patients must provide a valid Driver’s License or ID and an active​ insurance card at the time of service.
Currently we are not accepting New Medicare Patients, Medicaid, or Worker's Comp.