Forms
NEW PATIENT FORMS
Please take a moment to download and fill out your new patient forms. This will make our time together more efficient for you.
Click here for the New Patient Packet
The New Patient Packet includes 3 forms. If you do not have a printer, or cannot print the forms, please call our office and we will be more than happy to mail the forms to you..
Included in the packet is our HIPAA consent form. We respect your privacy and realize that you are placing a great deal of trust in us. There are times when it is important for us to discuss your medical history with other medical professions. This form gives us permission to do just that, discuss with other professionals, and NO ONE else!
The next form is our Health History Survey. Please answer as honestly as possible as this information is important to us. The more we know, the better and safer we can treat you! Our office does not discriminate based on any information on this form. We use it only for formulating safe treatment for you! This form is two pages.
The last form is our Cancer Screening form. We use a new technology in our office, the Identifi 3000®. Although it is not always covered by insurance, it is one of the most sensitive tests on the market. We are dedicated to the early detection and treatment for our patients. Please feel free to discuss this with us, the choice is yours.
In order to view the forms and download them you will need Adobe Acrobat Reader, click here if you do not have this free program.
Included in the packet is our HIPAA consent form. We respect your privacy and realize that you are placing a great deal of trust in us. There are times when it is important for us to discuss your medical history with other medical professions. This form gives us permission to do just that, discuss with other professionals, and NO ONE else!
The next form is our Health History Survey. Please answer as honestly as possible as this information is important to us. The more we know, the better and safer we can treat you! Our office does not discriminate based on any information on this form. We use it only for formulating safe treatment for you! This form is two pages.
The last form is our Cancer Screening form. We use a new technology in our office, the Identifi 3000®. Although it is not always covered by insurance, it is one of the most sensitive tests on the market. We are dedicated to the early detection and treatment for our patients. Please feel free to discuss this with us, the choice is yours.
In order to view the forms and download them you will need Adobe Acrobat Reader, click here if you do not have this free program.
