Printable Forms

Consent for Treatment:
Your consent to treatment and our use of your healthcare information to provide that treatment.

Our Financial Policy:
An explanation of our billing and collection policies and your agreement to abide by them.

Patient Registration Sheet:
All about you. Information we need to file insurance and maintain our records. All information is confidential!

Authorization to Release Information:
Who else can we talk to about you... parents, spouses, friends? Let us know.

Records Request Form:
Use this form to have your records at other facilities sent in to us.

Records Transfer Request:
Use this to have your records here copied or released to you or to another facility.