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When Making Appointments Note: More answers to frequently asked
questions (FAQ) can be found on our
FAQ page.
NEW PATIENTS
When you or your physician calls for an appointment, the phone attendant will
collect as much information as possible at that time. In order for our
physicians to provide the very best care, we will ask that you fill out several
forms before your first visit. You can do this at the appointment or print
off the forms below, complete them and bring them with you to your
first appointment.
Please read through the
Privacy Notice
posted on this website (available on this page for printing) and complete the
acknowledgement form (also on this page) stating you have received the Notice.
PLEASE NOTE: SCREEN PROMPTS THAT MIGHT APPEAR
Prompt #1: Password Prompt
Upon opening a form or exiting this page you may receive a
prompt for a login or password. Simply hit "cancel" or exit without inputting any
information. This prompt is a function of your browser's unique settings
and is not functional. If you were trying to open the form when the prompt
appeared, it should then open in Microsoft Word as normal.
Prompt #2: Save File Prompt
You should not make any changes to any form. However, if you
inadvertently make changes to the opened file, a dialog box may
appear that states: "This document has been modified. Do you want to
save changes?" Simply exit the document file by clicking "no".
Only print the original forms.
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| Instructions: |
This is a Microsoft Word file. Open
the file, print it, and fill it out PRIOR to your visit. This will
speed up your visit. |
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New Patient Information Form |
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| Instructions: |
This is a Microsoft Word file. Open
the file, print it, and fill it out PRIOR to your visit. This will
speed up your visit. |
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Medicare
Beneficiaries Form |
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| Instructions: |
This is a Microsoft Word file. Open
the file, print it, and fill it out PRIOR to your visit. This will
speed up your visit. |
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| Instructions: |
This is a Microsoft Word file. Open
the file and read it PRIOR to your visit. |
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Consent
to Leave Messages Form |
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| Instructions: |
This is a Microsoft Word file. Open
the file, print it, and fill it out PRIOR to your visit. This will
speed up your visit. |
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| Instructions: |
This is a Microsoft Word file. Open
the file, print out and read it PRIOR to your visit. Then open the
Acknowledgement Form below, print it, and sign it. Bring the
acknowledgement only to your first visit (not the Notice itself). |
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| Privacy Notice Acknowledgement |
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| Instructions: |
This is a Microsoft Word file. Open
the Acknowledgement Form, print it, and sign it. Bring it in for
your first visit. |
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| Instructions: |
This is a Microsoft Word file. Open
the file, print it, and fill it out PRIOR to your visit. This will
speed up your visit. |
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FMLA,
Disability, or Other Miscellaneous Form Completion Request |
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| Instructions: |
This is a Microsoft Word file. Open
the file, print it, and fill it out PRIOR to your visit. This will
speed up your visit. |
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