Patient Registration Forms 

• Patient Information Form.  Please complete this form prior to your visit.  Please give the completed form to our registration staff upon arrival.
• Privacy Practices Acknowledgement.  Please complete this form and give completed form to our registration staff upon arrival.  This form provides acknowledgement that you have received our notice of privacy practices.  It also allows you to designate other individuals to have access to your health record.

In addition to the above forms, please bring to your appointment:

• The referral for treatment from your physician.
• Your insurance information.
• Any referrals required by your insurance carrier.