Paperwork, Paperwork
| The three forms located below are
our standard forms we require for each patient prior to seeing
the patient for the first time. For new patients,
in order to save yourself some time when you come in for your
first appointment, please download, print, and fill out the
Patient Information &
Medical History Form, the Payment
Policy Form, and the HIPPA
Acknowledgement Form. |
|
 These
documents require the Acrobat Reader software. To download
and install a free version of Acrobat, click on the logo above.
|
| |
| For our current patients, if there are changes
in your medical status, insurance company, or contact information,
please download and fill out the relevent section on the Patient
Information and Medical History Form. |
Downloadable Forms
Patient Information &
Medical History Form
Payment Policy Form
Notice of HIPPA Practices
(You may just choose to read this on the screen, it does not need
to be filled out. The Acknoledgment form below does, however, need
to be filled out for each patient)
HIPPA Acknowledgement
Form
|
