Patient Forms

For convenience our patient forms are available on site in electronic format ready to be completed and printed before your visit to our offices.   This will save you time, making your visit more efficient.   Note that completing these forms on a smart phone will be difficult as they work better on a tablet, laptop or desktop computer.

When a form is opened, a new tab or browser window will open with the form open.   The Adobe reader (or equivalent) must be installed on your computer for this to work.

If using a device with the Safari browser, please note that the rendering engine does not display the interactive form fields. (applies to iPad, iPhone).   For details on how to get this working on these devices follow this link:   How to make our forms work on an iPad

Some forms have multiple pages.   Complete all pages before printing.   Note that some items to be circled must be done manually after the form is printed.

This form is to inform us of your medical history and register as a patient.   Please fill it in, print, sign and bring the printout with you to your appointment.

Medical History Questionnaire / Registration

This form indicates our compliance with the HIPAA law and filling it out, printing and signing before coming in will save you time and make your appointment go faster.

HIPAA Receipt / Consent Form

This form let you assign us to receive payments directly from your insurance provider.

Assignment of Benefits

Below is a link to our privacy practices.   If desired, the document may be printed.

Our Privacy Practices


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