Friday, May 16, 2025

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Practice Forms

Please complete first 5 forms in entirety and send to us via fax or email or bring with you on your first visit.

1. New Patient Information Form

2. New Patient History Intake Form

3. HIPPA Consent Form

4. Notice of Privacy Practices

5. Medical Records Release

Allows the patient to release medical records to another physician or obtain records from a previous physician.

6. Consent to Treat a Minor

Allows someone other than the legal guardian to consent to treatment of the minor