Patient Registration Forms & Privacy Notices
If you are a new patient, please fill out the forms listed below in advance of your appointment to assist the staff in making sure that we have all the information necessary to provide you with quality care and treatment. Please bring the completed forms with you to your appointment.
- Patient Registration
- Patient History
- Permission to Share Health Information
- Privacy Acknowledgement and Disclosure Agreement
- Screening Options
This privacy notice describes how health information about you may be used and disclosed and how you can get access to this information. Please review it carefully.
- Notice of Privacy Practices (provided for you at your first visit)
- Aviso Sobre Las Practicas De Privacidad (proporcionada por usted en su primera visita)
These forms require Adobe Reader. If you do not have Adobe Reader, you may download it free here: