Patient Forms
New Patient Registration
All New Patients must complete this registration before scheduling their first appointment. Remember, we need a registration for each child!
General Office Policies
All New Patients must acknowledge our General Office Policies.
This form was updated in November of 2020.
Patient Financial Policy
All New Patients must complete the Patient Financial Policy. If there are any changes for existing patients, please complete this form as an update to a patients account.
This form was updated in November of 2020.
Consent for Release of Information
This form is used to designate those you want to give permission to access the patients medical information. This form cannot be completed electronically for patient privacy reason. Please use this link to call our medical records team for more information!
Controlled Substance Agreement
If your child has been prescribed a controlled substance by our providers, this is a mandatory form.
Sliding Scale Fee Application
Please contact or visit our office for a complete Sliding Scale Fee Discount Application. As of 8/30/2024 we are working to update our website and the full application documents will be available to print from our website in the future.