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 Office Forms

Record Release Form


     The following forms are for informational purposes and will be signed electronically in the office at the time of your appointment:


Notice of Privacy Practices

Medicare Authorization

Non-Par Insurance Authorization

Participating Insurance Authorization

Consent & Authorization/Financial

Communication Consent

Health History Form Options

   1)  Print out using the following link and bring

       completed form to your visit  Health History


   2)   Complete health history questions

        electronically through Patient Portal LogIn.

               Portal Information Page 



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