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Welcome to our New Patient Forms page! To ensure your visit is streamlined and efficient, please find below a comprehensive list of the necessary forms. Thank you for choosing us for your healthcare journey.

New Patient Forms

  1. Health History Form (Required at First Visit)
  2. Notice of Privacy Practices Signature Page
  3. Parent Contact Information Form for Minors (19 and younger)
  4. Medicare Secondary Payer Form (only complete if covered by Medicare)

Disclosures

  1. Notice of Nondiscrimination and Accessibility (Aviso de No Discriminacion y Accessibilidad)
  2. Language Assistance Taglines
  3. Financial Policy
  4. Notice of the Right to Receive a Good Faith Estimate
  5. Notice of the Rights and Protections Against Surprise Medical Bills
  6. Notice of Privacy Practices (NPP) HIPAA

Medical Records Request

  1. Authorization to Disclose Information