New Patient Paperwork

DownloadButtonNew Patient Paperwork
(for private insurance, self-pay or worker’s comp patients)

Attendance Policy Form • Health Questionnaire • Patient Authorization Record

Please print, complete and sign all pages. Bring completed paperwork with you to your scheduled evaluation, along with any current insurance cards and identification.

 

DownloadButtonNew Patient Paperwork
(for Medicare patients)

Attendance Policy Form • Health Questionnaire • Patient Authorization Record • Medicare Secondary Form

Please print, complete and sign all pages. Bring completed paperwork with you to your scheduled evaluation, along with any current insurance cards and identification.

 

DownloadButtonHIPPA Statements – Please Read Prior to Initial Visit (all patients)

This document discusses our privacy policies, how information about you may be disclosed and how you can have access to your patient information. You are not required to print this for your patient file.