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To save time before your first visit to our clinic, you may choose to print and complete the following forms and bring them with you. These forms are in PDF format, and you will need Adobe Acrobat Reader to view them.
- Health
History Questionnaire for Patients (4 pages, 153 kb)
- Acknowledgement
of Receipt of Notice of Privacy Policies (1 page, 26 kb)
- Patient's
Consent For the Purposes of Treatment, Payment And HealthCare Operations
(1 page, 39 kb)
- Basic
Information (1 page, 11 kb)
You may also view the following information about the clinic's policies,
services and
fees before your first visit.
- Office
Policies (1 page, 41 kb)
- Notice
of Privacy Policies (1 page, 47 kb)
- Schedule
of Fees (1 page, 60 kb)
- Insurance
Information (1 page, 28kb)
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