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You are here: Home Documents & Forms

Documents and Forms

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Instructions

You may print off each form (as needed) and then fill it out and bring it in with you at your next appointment

Patient Forms

  • Patient Registration and Consent Form
  • Authorization to Share PHI
  • Informed Consent for Telemedicine Services
  • Notice of Privacy Practices (April 2017)
  • Financial and Clinic Policy

Additional Documents

  • Medical Records Release Form (Nov 2017)
  • Medical History Questionnaire (Oct 2019)

Note: Forms will open in a new window

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