New patients will be required to complete the following sign-in forms on arrival at the clinic.
- Patient Registration Form
- Protected Health Information Form. This form provides us with your authorization as to how we may contact you with any relevant follow-up information (such as laboratory results)
- Acknowledgment of Receipt of Privacy Practices Form (Notice of Privacy Practices)
You may print out these forms and bring in your completed forms if you wish to save time on your arrival at the clinic. If you have questions about how to complete the forms please ask us when you arrive at the Clinic.
Medical Records Release
If you would like a copy of your medical records please complete our Authorization to Release Medical Records form and fax it to us at 303-683-9392.
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