Forms
During your appointment, you will need to answer some important questions so that you and your health professional can plan your care together. The following forrms are provided to you as tools to help you prepare for and make the most of your doctor visit.
To save time, you may print the forms and complete them before your appointment, and bring them with you.
Please remember to bring a current list of your medications, a current insurance card and your co-pay along with your completed forms to your appointment.
- New Patient Registration
- Financial Policies
- Notice of Privacy Practices for the Usage and/or Disclosure of Protected Health Information
- Authorization for Disclosure of Health Information
- Notice of Privacy Practices
- Acknowledgement of Receipt of Privacy Practices
- Financial Policies - Spanish (Poliza Financial - Espanol)
- General Surgery Intake Questionnaire
- Mammography Questionnaire
- Screening Questionnaire for Adult Immunization
- Screening Questionnaire for Child and Teen Immunization
- Screening Questionnaire for New Orthopedic Patients
- Screening Questionnaire for Orthopedic Hip Patients
- Screening Questionnaire for Orthopedic Knee Patients
- Screening Questionnaire for Orthopedic Shoulder Patients
- Patient Medical History Questionnaire
