Please print, fill out, and bring these forms to your first appointment.
- Confidential Health History
- Registration Form
- Financial Policy Agreement
- Voicemail Consent
- Chaperone Consent
- HIPAA Acknowledgement of Receipt
For any appointment, please bring:
- A photo identification card
- Your current insurance card
and be prepared for any co-payments your insurance plan requires; co-payments are due on your date of service
If you are coming to our clinic for your preventative visit, please read this flyer on the difference between a Preventative Visit vs. an Office Visit.
Authorization for Release of Medical Records
The following form requiring your signature is necessary before any records can be released to us.
The following form requiring your signature is necessary before any records can be released FROM us.