|
 FORMS
COMPLETION STEPS
Don't like
to wait on hold? Why not request your appointment online! Do you
dislike filling out forms at your doctor's office? Why not fill
them out online in the comfort of your home or office with all of
the information you will need at your fingertips!
Simply complete each of the following 6 steps.
STEPS
1 THROUGH 3 ONLY MAY BE COMPLETED ONLINE.
STEP
1 > Request your appointment
online. Click the link to complete your request.
Request
on Appointment
STEP
2 >
Patient Registration. Click the link to complete your Patient Registration
Form.
Patient
Registration Form
STEP
3 >
Patient History. Click
the link to complete your Patient History Form.
Patient
History Form
______________________________________________________
Please
print the following forms, sign and date them and bring them with
you to your appointment. These forms cannot be submitted
online.
Your will need Adobe Acrobat to view and print these forms. If
you do not have Adobe Acrobat, please click the Acrobat icon and
download your free copy.
STEP
4 > Payment
Policy. Please read the Payment Policy, print a copy, sign and
date it and bring it with you to your appointment. Please print
a copy for yourself as well. Click the link to view the Payment
Policy.
Payment Policy
STEP 5 > Acknowledgment and Consent.
Please read the Acknowledgment and Consent, print a copy, sign
and date it and bring it with you to your appointment. Click the
Acknowledgment and Consent link to view the
form.
Acknowledgment
and Consent
STEP
6 > Privacy Policy. This is for your information
only, you do NOT need to bring this with you to your
appointment.
Privacy Policy
Return
to To
|
