Welcome to Our Practice!
As a new patient, there is a great amount of information we need to build your medical record. In order to expedite this process, we have put the forms on our website for you to print and fill out and bring with you to your first visit.
You will find the following forms that can be printed when you click the button below:
- Request for Medical Records
This is for our office to obtain your records from your previous Dr/Drs. Including their phone number or fax number would be very helpful.
- Patient Portal Agreement
When you come for your first visit, you will get a username and password to log into the Portal; this is a protected site for you to get your medical information.
- Financial Policy
Explains the office policy regarding co-payments…etc.
- Authorization for Disclosure of Health Information
This form is for you to tell us who we can share your medical information with. We cannot share any information, even in an emergency unless you specify who we can discuss your information with.
- Health Care Proxy
All patients must have a Health Care Proxy on file in our office. If you do not have a Proxy, the Dr’s cannot make emergency medical decisions on your behalf. if you already have a Health Care Proxy, bring a copy – there is no need to fill out a new one.
- HIPAA Notice of Privacy
You must bring the signature page, signed.