Patient Forms
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FYI: Photo ID Required
To protect our patients and ensure compliance with insurance regulations, we require a valid photo ID for all individuals receiving care. This can be one we take in-office, or a government-issued ID such as a driver's license, passport, or state ID card. This policy helps us prevent identity theft and insurance fraud. If a patient is unable or unwilling to provide photo identification, we will respectfully assist them in finding an alternative clinic.
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Release of Information
This form allows us to release your medical records or request your records from another office.
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Office Policies
Description of our policies including no-show appointment fees.
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Notice of Privacy Practices
Our office is HIPAA compliant, which means that we will not share any information about you or your appointments with anyone other than you.
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Patient Rights and Protections
The rights and protections against surprise medical bills.
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Good Faith Estimate
You have the right to receive a “good faith estimate” explaining how much your health care will cost.