Patient Instructions

New Patient Forms

In order to facilitate the registration process, please arrive 15 minutes before your appointment time.

Please have the following forms printed, filled out (in the language of your choice) and present them at your initial visit along with your picture ID, insurance card(s), and copay (if applicable).

• Registration  (English)
  • download form 
• Registration (Spanish)
  • download form
• Registration Form (Polish)
  • download form
• Authorization for Release of Confidential Medical Information (English)
  • download form
• Authorization for Release of Confidential Medical Information-Minor (English)
  • download form
• Authorization for Release of Confidential Medical Information (Spanish)
  • download form 
• Authorization for Release of Confidential Medical Information-Minor (Spanish)
  • download form
• Medical History (English)
  • download form 
• Medical History (Spanish)
  • download form
• Financial Policy (English)
  • download form
• Financial Policy (Spanish)
  • download form
• HIPAA Notice of Privacy Practices (English)
  • download form
• HIPAA Notice of Privacy Practices (Spanish)
  • download form