Forms and Policies
Click on the appropriate forms below. If you are a new patient and have been accepted to our practice, please complete the forms that have a star (*) next to it and bring them to your appointment; along with patient(s) insurance card. This will help speed your check in process. Thanks for your cooperation.
New Patient Forms
- New Patient Registration - English **Please fill out one registration form per family**
- New Patient Registration - Spanish
- Medical Records Request
(Please complete if you are requesting records from another doctors office to be sent to our practice) - Authorization Consent for Disclosure of Protected Health Information
(Please complete if you are transferring out of our practice and would like us to forward your records to your new provider) - HIPAA Notice of Privacy Practices
(Your rights as a patient)
Established Patients
ADHD Forms
Insurance