Before arriving for your first appointment please download, print and complete the following forms:
- Patient Intake
- Medical History
- Acknowledgment of Financial Responsibility
- Receipt of Notice of Privacy Practices
The Notice of Privacy Practices can be viewed here: Notice of Privacy Practices.
If you need us to request your Protected Health Information from a third party or you need us to release your PHI to someone, please complete the Release of Protected Health Information.
If you prefer to fill out the forms at the clinic when you come for your first appointment, please arrive 15 minutes early to give yourself enough time to complete the forms.
The forms are PDF files. To download and print the forms, you’ll need the free Adobe Acrobat Reader program.