The forms below are provided as a courtesy to our new patients. You may print them, fill them out, and sign them ahead of time. Bring them with you to your initial appointment along with your insurance card, driver's license (or photo ID), and your cash copay. You will also need your own and your policyholder's social security numbers and both of your birthdates including the birth year in order to bill your insurance.
We look forward to meeting you!
- New Patient History
- Patient Registration and Insurance Sheet
- HIPPA Consent
- Authorization for Services
- HIPPA Policy (Print for your records if you desire)