In an attempt to make the administrative process flow as smooth as possible, three forms are provided–Physician Referral Form, Initial Intake Information and Notice of Privacy Practices. To access the forms, please click on the links highlighted below.
This set of forms are for intake purposes. They include five forms over seven pages:
- Patient Registration Information
- Individual Patient’s Authorization
- Financial Policies
- Authorization of Treatment
- Confidential Patient Medical History
Please print out the forms, fill them out, and bring them with you on your first visit. If you have difficulty with downloading or printing the forms, let me know.
Please read over this statement regarding your privacy. You will be asked to sign confirming you have read and understand your rights.