FORMS |

To make your visit as seamless and as comfortable as possible, we have provided the information below for your convenience.

POLICIES AND PROCEDURES

FORMS

BINDING ARBITRATION

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Home » BEFORE YOUR VISIT » Forms

FORMS

NEW PATIENTS:

If you're a first time patient, we’d like to help speed you through your initial appointment with us. Take a moment to print and complete the following forms. Be sure to bring them with you.

To Our New Patients	>>Download Form Now
Binding Arbitration	>>Download Form Now
Notice of Privacy	>>Download Form Now
Receipt of Privacy Notice	>>Download Form Now
Patient Information	>>Download Form Now
Financial Agreement	>>Download Form Now
Health History Questionnaire	>>Download Form Now

EXISTING PATIENTS:

From time to time, you may require for us to release a copy of your records to another medical institution. To do so, you must fill out a Medical Release form.

Medical Release form.

>>Download Form Now

WEIGHT LOSS PATIENTS:

Those patients joining our Weight Loss program will need to fill out a number of forms prior to their first visit.

Diet and Exercise History	>>Download Form Now
Patient Release	>>Download Form Now

VISIONS 4D ULTRASOUND PATIENTS:

Patients using our elective Visions 4D Ultrasound services will need to fill out a consent form and a DVD request form prior to their appointment.

Medical Release form.

>>Download Form Now