Patient Forms

New Patient Registration FormFill out this form prior to a new appointment
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Patient Record of DisclosuresIn general, the HIPAA privacy rules give individuals the right to request a restriction on uses and disclosures of their protected health information (PHI). The individual is also provided the right to request confidential communications or that a communication of PHI be made by alternative means, such as sending correspondence to the individual’s office instead of the individual’s home.
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Assignment of BenefitsAuthorization to release medical information.
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Medicare Secondary InsuranceSignature on file.
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