In an attempt to improve the patient
experience at both of our clinics, we have made the Patient Information & Health
History Questionnaire Forms available below in .pdf
format.
This will give you the opportunity to complete the
forms in the comfort of your own home. The .pdf file
is able to be filled in using Adobe Reader© and printing
the forms out when finished. Or, you can print
the forms and fill them out by hand.
To access the forms, simply select the desired
link below to open the file.
 Patient
Information Forms
Health History
Questionnaire
In
addition, if you would like to take a few moments and review the
Summary of Our Notice of Privacy Practice Act by following
this HIPAA link. Then, you can print off and sign
the acknowledgement page for this as well. The only thing
you should have left to do is verify your insurance information with
the receptionist when you come into the
office!
Acknowledge Receipt of Summary of Our Notice of Privacy
Practice
If you don't have Adobe
Reader© on your Computer, click the link below to be automatically
redirected to the Adobe© Download Site for the most rescent
version:
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