Patient Forms

Patient Welcome Packet Contains: 

  • Patient History
  • Patient Missed Appointment Policy
  • Financial Office Policy
  • Financial Responsibility and Assignment of Benefits Policy
  • Patient Acknowledgement of Privacy Practices
  • Patient HIPAA Consent Form


Advance Beneficiary Notice (ABN) - Medicare only  (select option 2)


Athlete Waivers and Forms 

 

  • Athlete Participation and Health History Form.
  • General Liability Waiver


Items to bring to your first visit

  • Identification Card (Driver's License, Student ID, or Passport)
  • Insurance Card
  • Completed Patient  or Athlete Intake Forms.