Download / Print: Office Forms

YOU MAY DOWNLOAD THE FORMS BELOW:

• Please have a PDF Reader installed. If not, click here to get one.
• Click the file to download and save to Desktop or Downloads folder for easy find.



NEW PATIENT

• New Patient Packet (PDF)
  This includes: welcome letter, registration form, medical history, birth history, HIPAA privacy forms (2), financial policy and IQHealth - patient portal access form.

HIPAA PRIVACY

• HIPAA Privacy Form(s)
  

MORE PATIENT FORMS

• Authorization for Disclosure of Health Information
• Refusal to Vaccinate
• Financial Policy
• IQHealth Form for Patient Portal Login

PLEASE READ:

You may print, fill out the form(s) by hand and bring with you on the day of your visit. For your protection, we ask that you DO NOT email us information concerning billing or health issues.