Patient Registration Forms & Privacy Notices
If you are a new patient, please fill out the forms below and bring them to your first appointment. This will assist the staff in making sure that we have all the information necessary to provide you with quality care and treatment.
- Patient Registration
- Patient Consent
- Medical Records Release
- HIPAA Acknowledgement Disclosure Consent
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.
- Notice of Privacy Practices (provided for you at your first visit)
- Aviso Sobre Las Practicas De Privacidad (proporcionada por usted en su primera visita)
These forms require Adobe Reader. If you do not have Adobe Reader, you may download it free here: