Forms and Policies

Click on the appropriate forms below. If you are a new patient, please complete the forms that have a star (*) next to it and bring them to your appointment; along with patient(s) insurance card. This will help speed your check in process. Thanks for your cooperation.

• New Patient Registration - English    **Please fill out one registration form per family**
• New Patient Registration - Spanish
• HIPAA Consent Form
• Payment Policy
• Medical Release Form
  (Please complete if you are requesting records from another doctors office to be sent to our practice)
• Authorization Consent for Disclosure of Protected Health Information
  (Please complete if you are transferring out of our practice and would like us to forward your records to your new provider)
• Preparticipation Physical Examination Form
  (Please complete prior to your physical and bring to our office at time of exam)
• HIPAA Notice of Privacy Practices
  (Your rights as a patient)
• Immunization Consent Form
• ADHD Teacher Questionnaire
  (Vanderbilt Assessment Scale)
• ADHD Parent Questionnaire
  (Vanderbilt Assessment Scale)