Please take a moment to review and complete the appropriate forms. This will allow us to complete the new patient enrollment process as quickly as possible when you arrive at our office.

Thank you.

 

1.   CONFIDENTIAL INTAKE FORM

This helps us gather some basic information about you like name, address, referring doctor, etc.

2.   PRIVACY NOTICE INFORMATION

This is a listing of your rights as a patient and our responsibilities for safeguarding your health information.

 

3.   PATIENT PRIVACY

We will give you a copy of our privacy policies and this acknowledges your receipt.

 

4.   SIGNATURE ON FILE

An acknowledgement of the authority to release financial and medical information in furtherance of your treatment.