For your convenience, print, fill out and bring in the following forms to your first visit:
- New Patient Registration Form
- Adult Health History Form – Appropriate for patients 18 years and older.
- Adolescent Health History Form – Appropriate for patients 13 to 18 years
- Authorization for Release of Medical Information Form
- Pediatric Health History Birth to 12 Years
- I-Q Health Form
- Family History Form
- New Patient Information & Policies
- Insurance Participation
- Notice of Privacy Practices
- Acknowledgement of Receipt of Notice of Health Information Practices Form
- Prescription Refill Request – Print, fill out and fax.