We are required to have full identification of all our patients and so we ask you to fill out a patient information form when you come to our office. We will bill your insurance for you as a courtesy, but insurance companies and other third-party payers will not respond unless we provide them with full identification. We will also ask you to update your forms annually. All the forms are kept confidential in your medical record. You can make your visit to our practice more efficient by downloading our forms, filling them out, and bringing them with you to your appointment. Each document is in Microsoft Word (.doc) and (.pdf) formats:

PATIENT REGISTRATION
Word .doc
.pdf

PATIENT MEDICAL HISTORY
Word .doc
.pdf

PATIENT FOLLOW-UP
Word .doc
.pdf

Patient Registration Form

FINANCIAL POLICY
Word .doc
.pdf

HIPPA NOTICE/DISCLAIMER
Word .doc
.pdf

HIPPA CONSENT
Word .doc
.pdf

 

 

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