Patient Registration Forms & Privacy Notices
If you are a new patient, please fill out the registration forms listed below in advance of your appointment to assist the staff in making sure that we have all the information necessary to provide you with quality care and treatment. Please bring the completed forms with you to your appointment.
Download the complete patient forms PDF package.
Or download individual forms:
- General Consent for Care and Treatment Consent
- Patient HIPAA Acknowledgment & Disclosure Consent (printable) — complete this form
- HIPAA Consentimiento— complete este formulario
- Patient History Form
- Patient Registration Form
- Patient Medication List
- Flu Vaccine Information Form
- Vacuna contra la gripe Hoja De Información Sobre Vacunas
- Consent Form for Seasonal Influenza Vaccine
- Documento De Consentimiento Para Recibir La Vacuna Contra La Influenza
Patient Rights & Responsibilities
We respect our patients’ dignity and pride. This document will explain your patient rights and responsibilities. It is part of your patient registration and is an important part of your health care plan.
This privacy notice describes how health information about you may be used and disclosed and how you can get access to this information. Please review it carefully.