For your convenience and to avoid delay on your first visit with us, you can use the links below to download and print the forms and notices we’ll ask you to read, complete and sign.
Note that, for privacy and signature purposes, we cannot accept this information online. Please print out the forms, complete and sign them as needed, so that you can bring them when you visit. If you have any questions, or if you prefer to have the forms mailed or faxed to you, please contact us toll-free at 1(800) 997-1725.
- Click the the Form Name link to print a form directly from your web browser, or
- Click the icon to download the Adobe Acrobat* version of the form.
Describes how your health information may be used and disclosed, and your rights regarding this information. Please read it carefully.
Our privacy policies. Please read and sign.
Our financial policy. Please read and sign.
Your patient information. Please fill out and sign.
Patient History Form
Information about your current and past medical status. Please fill out as completely as possible.