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New Patient Paperwork/Forms

NEW PATIENTS:

Patient portal registration information will be emailed to you. Once completed, you will have to complete one more short form at the office. 

If you are unable to complete the registration on the patient portal prior to the appointment, please print and complete these forms prior to your first appointment or arrive 15 minutes earlier to complete them.

New Patient Forms:

New Patient Intake Form - CLICK HERE

General Policy and Financial Form - CLICK HERE

HIPAA Consent Form - CLICK HERE

Other Forms:

ABN Form - for Medicare patients only

Medical Record Request Form - only if you need us to send your medical records somewhere

Patient's Forms
New Patient Appointment

Before Your First Appointment Visit

Please arrive 15 minutes before your appointment time to fill out new patient intake paperwork. If you printed the forms out online and filled it out at home, please arrive 5 minutes prior to your appointment time to check in. 

Please have the following information with you at the time of visit.

  • Driver license or photo ID

  • Current health insurance card(s) (please make sure we are in network. If in doubt, contact your insurance)

  • List of current medications (prescription, non prescription, and herbals)

  • Co-payment - we are required to collect co-payment prior to service

Please keep in mind that if you are more than 15 minutes late you will need to reschedule. Please call the office to cancel or reschedule within 24 hours of your appointment or you will be charged a $25 no show fee.

No Show Policy:

No shows are an inconvenience to patients who need access to medical care in a timely manner. Therefore, we charge $25 for missed appointments. 

If you are unable to make it to your appointment, please give us a call. If you missed an appointment, you may be charge a $25 no show fee.

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