PLEASE DOWNLOAD THE FOLLOWING FORMS AND BRING THEM WITH YOU TO YOUR FIRST SCHEDULED APPOINTMENT WITH US.  MAKE SURE THE FORMS ARE FILLED OUT COMPLETELY & PROVIDE US WITH YOUR CURRENT INSURANCE INFORMATION SO WE MAY VERIFY ALL COVERAGE PRIOR TO YOUR APPOINTMENT.  IF THE INSURANCE IS NOT VERIFIED DUE TO MISSING OR INCOMPLETE INFORMATION, WE MAY HAVE TO RESCHEDULE YOUR APPOINTMENT. 

IF YOU LIKE, YOU MAY ALSO FAX OR MAIL THEM TO US PRIOR TO YOUR APPOINTMENT.         HOWEVER, WE STILL NEED YOU TO BRING THE SIGNED ORIGINALS.

REGISTRATION FORM

MEDICAL HISTORY FORM

FINANCIAL AGREEMENT

HIPAA RECEIPT OF NOTICE

HIPAA RIGHTS TO PRIVACY STATEMENT PG 1

HIPAA RIGHTS TO PRIVACY STATEMENT PG 2

PLEASE CALL OUR OFFICE IF YOU HAVE ANY QUESTIONS OR CONCERNS.