New Patient Form

Please print, fill out, sign and initial this form and bring it to the office on your first appointment day.

   HIPAA Notice of

Privacy Practice

This is our “HIPAA Notice of Privacy Practice”  for your information and reading.  

New Patient Forms

On your first appointment day:

• Please bring your driver license and insurance card on your first appointment day. 

• If you don’t have driver license please bring a state-issued photo ID.

• Please bring your medical records with you on the appointment day.

• In addition to the above "new patient form", you need to fill out and sign other forms in the office including the arbitration agreement form and other forms.