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Forms

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

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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

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Adult Patients:

Informed Consent (Adult)

Adult History Form

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Private Pay / Forensic Cases:

Fee Schedule Contract

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If you are experiencing difficulties viewing these forms, please download

Adobe Acrobat Reader, which is free to use.  It is available to download here.

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