| Welcome to our forms page. For
your convenience, we have made the following forms and documents
available for download. Please read the instructions
for each form.
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• New
Patient Registration Form
-
Click here to download our "New Patient Registration"
form. Print and complete the form prior to your appointment. This
will save you time when arriving for your first appointment.
• Notice
of Privacy Practices Form
- Click here to download our "Notice of Privacy Practices"
statement. This notice is, as required by HIPAA, to inform our patients
of our privacy practices and our patients' rights.
• Acknowledgement
of Receipt of Notice of Privacy Practices Form
-
Click here to download our "Acknowledgement of Receipt of Notice
of Privacy Practices Form". This form acknowledges that you
have received a copy of our "New Patient Registration".
Print and complete the form prior to your appointment. This will
save you time when arriving for your first appointment.
• X-Ray
Request Form -
Click here to download our "X-Ray Request" form. Print
and complete this form if you wish to have your X-Rays released
to you. This form is required by HIPAA to protect patient confidentiality.
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