Feel free to download and complete these forms at your convenience and then bring with you to your first appointment.
REQUEST FOR RELEASE OF OUTSIDE RECORDS
PATIENT MEDICAL INFORMATION FORM
PATIENT AUTHORIZATION TO USE AND DISCLOSE PHI (PROTECTED HEALTH INFORMATION)
YOUR INFORMATION. YOUR RIGHTS. OUR RESPONSIBILITIES.
PERMISSION FOR VERBAL COMMUNICATIONS
NONDISCRIMINATION AND ACCESSIBILITY REQUIREMENTS: DISCRIMINATION IS AGAINST THE LAW