TO PRINT FORMS: Select the link below to open the applicable forms in PDF format [it may take a moment for the page to load].  When the document is displayed, click the "Print" icon in the upper left corner of the document.  [Click HERE if you receive a message stating you need to dowdnload Adobe PDF Reader to print]  When printing is complete, click your browser BACK arrow to return to this page. 

• NEW PATIENT Forms  (complete all if you are using insurance benefits)

1. Patient Information Sheet  
2. Patient Medical History Questionnaire (2 pages)
3. Authorization to Bill Insurance/Consent & Release Form
4. Cancellation Policy
5. Notice of Privacy Practices

• MEDICARE Benefits Information  (if you are using MEDICARE benefits, complete this form IN ADDITION to the New Patient forms above)

• SELF-PAY Patient Information Sheet  (complete this form IN LIEU OF form #1 above ONLY if you are NOT using insurance benefits) 

• See FAQ #2 & #3