Welcome! We look forward to providing you with excellent care.
Prior to your first visit please print the following forms, complete, sign and bring them with you to your appointment.There are 4 separate forms, the last of which is 2 pages, so you should have 5 pages total when complete.
1. Acknowledgement of Notice of Privacy Practices
2. Medical Release Authorization/Financial Responsibility and Insurance Assignment
3. New Patient Information
4. History & System Review (2 pages) --OR--
4. Youth History & System Review (2 pages for 12 and under)
