New Patient Information

All new patients are required to fill out the following new patient documents. Please click on each document below to print, fill out and bring with you on your first visit.

(You must have Adobe Reader installed in order to view and print the documents below)

1. Health Insurance Claim Form (HICFA)
2. New Patient Information Page (English) or
   Página Paciente Nueva De la Información (En Espanól)
3. Assignment of Benefits and Consent Form
4. Records Release Form
5. Acknowledgement of Receipt of Notice of Privacy Practices