Forms

Form #1: Privacy Policy / HIPAA (Note: This form is for you to keep)

Form #2: Notice of Privacy Policy / HIPAA Receipt
(ALL Patients: please bring with you to your first appointment)

Form #3: Consent to Release Information
(ALL Patients: please bring with you to your first appointment)

Form #4: Adult Patient Registration –  Part A
Form #5: Adult Patient Registration –  Part B
(Adult Patients: please bring with these two with you to your first appointment)

Form #6: Child and Adolescent Patient Registration
(Child and Adolescent Patients: please bring with you to your first appointment)

Form #7: Treatment Consent
(ALL Patients: please bring with you to your first appointment)

Form #8: No Show Policy
(ALL Patients: please bring with you to your first appointment)