Please print and fill out these forms so we can expedite your first visit:
- HIPPA/Assignment of Benefits
- HIPPA/Personal Representative
- HIPAA/Omnibus Notice of Privacy Practices
- Telehealth E-Visit Reimbursement Form
- Civil Rights Statement October 2016
- Information for Individuals with Limited English Proficiency
- Parental Consent to Treat Minor Child
- Patient Financial Agreement
In order to view or print these forms you will need Adobe Acrobat Reader installed.
Click here to download it.