Notice of Privacy Practices

THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

Patient Forms

Please complete these forms before your first visit. It will save us time in setting up your patient file — and reduce the amount of time you spend in our waiting room.

Also, please bring with you a valid photo ID (such as a driver’s license or passport) and your current insurance card.

You may complete them online.  Or, if you prefer, there are pdf versions available to display and print.  A right-click will allow you to download the pdf’s directly to your computer.  The “full patient packet” contains all the forms in a single pdf for more convenient display and download.

Step 1

Step One

Fill out the General and Insurance Information form: Download PDF or  Complete Online

Step 2

Step Two

Fill out the Authorization for Use and Disclosure of Protected Health Information form: Download PDF or Complete Online

Step 3

Step Three

Complete the following forms online:
Medical History
Procedures and Lab Work
Conditions
Surgical
Family History
Medications and Allergies

You can also download a PDF version of these forms for offline completion.