The following forms are provided for your convenience:
Here you will find documents to assist you in obtaining the smoothest care at our facility.
All new patients to our clinic are required to fill out the “patient registration” form to the left. Completion of this form prior to arrival at our facility helps check-in go more fluidly.
Whether you are coming to our facility or perhaps moving to another area, you may find the “medical record release” form to the left to be just what you need. New patients coming to the practice with this completed ahead of time will ensure we obtain your records as quickly as possible, assisting our doctors in your care.
Beginning January 2012, the Centers for Medicare and Medicaid Services (CMS) is requiring the “Medicare Wellness Exam Questionnaire” you can find to the left as part of the newly allowed annual wellness exam. Completion of this form prior to your visit will greatly assist the provider in your care. Please note that Medicare still does not cover regular physicals at this point in time. For an explanation of the difference between a Medicare wellness exam and a standard physical, please visit this link.