Forms

Please download and complete the patient registration forms and bring them with you on your initial visit, along with your insurance card and any medical records you might have. I hope that by making these forms available in advance of your visit you will find it easier to gather all the necessary information. Having all of this information in your record correctly is the first step to good healthcare.

The patient registration forms are contained in a single PDF that can be opened and filled out on your computer. After downloading the forms, they may open automatically in your browser. If they do, please do a "save as" and save them with a file name that includes your name. Then open that file using the current version of Adobe Acrobat Reader, enter your information, and do a "Save" from the File menu to save the information. If you fill out the form in your browser, you can print the document but the information you have entered will not be saved and you can not e-mail the form. 

When you have completed the forms, print and sign copies to bring with you. Also e-mail the completed forms to me at the e-mail address shown on the forms. This will enable me to start creating your healthcare record immediately, and it provides a backup in case you forget to bring the forms.

The Notice of Privacy Practices provides information about how I protect the privacy of your medical information, and what your rights are to access and control the sharing of that information. You can print a copy from your browser if you wish to keep it for your records.