Patient Forms

Download and complete our patient forms and bring to your visit for fast processing.
— General Patient Forms —

Streamline Your Medical Records

Simplify your visit and save time by filling out our patient forms before your appointment.
Authorization for Release of Medical Information (PDF)

Authorization for Release of Medical Information (PDF)

Authorizes disclosure of health information to designated parties.
Download document
Authorization and Consent for Treatment (PDF)

Authorization and Consent for Treatment (PDF)

Consent required for treatment, communication, and financial responsibility.
Download document
Preferred Contacts (PDF)

Preferred Contacts (PDF)

Patients are encouraged to complete and return the Preferred Contacts Form but it is not required.
Download document
Virtual Visit Policy (PDF)

Virtual Visit Policy (PDF)

This policy describes the process for the documentation, maintenance, and transmission of information using virtual visit technology.
Download document
— Office Policies —

Navigating Our Office Policies for Efficient Service

These policies serve as a guide to help you navigate various aspects of your visit, from scheduling appointments to understanding our billing procedures.
Financial Policy (PDF)

Financial Policy (PDF)

This form advises patients of their complete financial responsibility for all medical services received without regard to insurance eligibility or coverage determinations.
Download document
Notice of Privacy Practices (PDF)

Notice of Privacy Practices (PDF)

Describes how health information about you (as a patient of this Care Center) may be used and disclosed, and how you can get access to your individually identifiable health information. Please review this notice carefully.
Download document

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