Forms

Please open and complete the relevant forms below prior to your appointment to save time and to enhance the quality of your care:

All Patients:

Patient Information Form

Financial Policy

Notice of Privacy Practices (HIPAA)

Authorization to Release Confidential Information (optional)

 

Child Patients:

Informed Consent (Child)

Child History Form

Adult Patients:

Informed Consent (Adult)

Adult History Form

Private Pay / Forensic Cases:

Fee Schedule Contract