Appointments/Forms

If you have access to a printer, please open the forms below, print them out and complete prior to your initial visit.

Medical History Form

Patient Demographics Form

HIPAA Form

HIPAA Policy Acknowledgement

Patient Notice of Policies  

Request for Medical Records

Due to confidentiality, we will only accept requests from you or recognized insurers. If you wish to obtain copies of your files, you must sign a records release form.

 

 

Payment Options

We accept American Express, MasterCard and Visa credit cards. We also accept personal checks and cash payments.

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