Print and fill out these medical forms and bring them with you to expedite your check-in process.
|Download Patient Registration
|Advance Beneficiary Notice (ABN)
|Download Advance Beneficiary Notice
|Patient Consent Form (HIPAA)
|Download Patient Consent Form
|HIV Consent Form
|Download HIV Consent Form
|Medical Release Form
|Download Medical Release Form
|Download Medical History
Paying by Credit Card?
Please fill out this form, bring it with you, email or fax it to us.
|Credit Card Authorization Form
What you’ll need on your visit:
|All current insurance cards
|One (1) Official picture ID (Driver’s license, passport…)
|Co-pay is expected prior to being seen, no personal checks acceptable.
|Please arrive on-time