Forms

Consent for Treatment Your consent to treatment and our use of your healthcare information to provide that treatment.
Our Financial Policy An explanation of our billing and collection policies and your agreement to abide by them.
Patient Registration Sheet All about you. Information we need to file insurance and maintain our records. All information is confidential!
Authorization to Release Information Who else can we talk to about you... parents, spouses, friends? Let us know.
Records Request Form Use this form to have your records at other facilities sent in to us.
Records Transfer Request Use this to have your records here copied or released to you or to another facility.