New Patient Forms

• Authorization For Use and Disclosure of PHI under 18 years old
  
• Authorization For Use and Disclosure of PHI over 18 years old
• Failure to Keep Appointment Policy
• Medical Records Release FROM our Clinic
• Medical Records Release TO our Clinic
• Notice of Privacy Practices (NPP)
• Vaccine Consent Form
• Privacy Practices Acknowledgment & Patient Consent for Use and Disclosure of Protected Health Information
• Patient Medical History
• Patient Registration​ - Under 18 years old