Patient forms

In an effort to use less paper, our office utilizes electronic medical records. The forms below are required of every patient and we have the links here if you would like to review them. We do, however, use laminated forms and dry-erase markers in the office for this information which we then scan into your electronic medical record and then wipe clean. This removes the need to shred and discard (recycle) paper forms in the office. You are, of course, welcome to download, print, and fill out these forms in advance of your office visit and bring them with you if that is more convenient. Please let us know if you have any questions.

Patient Registration Form [pdf]
General patient information.

HIPAA Form [pdf]
HIPAA legal rights pertaining to privacy and OPTOS waiver.

Advanced Beneficiary Notice [pdf]

Adobe Acrobat

These forms are pdf documents. Download the latest version of Adobe Acrobat Reader to view them.