Patient Forms

The links below will provide you with our patient forms. Please click on the link appropriate to your situation. Then, print them out, complete and bring them with you when you come in for your first visit.

Everyone

Everyone must complete the:

• Patient Information Form

Insurance "Quote of Benefits"

• Medicare
• Auto/ No Fault
• Blue Cross/ Blue Shield
• Aetna
• All Other Insurances

No Insurance Coverage

• Self Pay Agreement

Notice of Privacy Practices

• For your records only. You are not required to download and sign this form as your acknowledgement of these practices is noted in the above paperwork. But, the Notice of Privacy Practices is available for you to download and complete, if you choose to do so.

What to Bring

• Physician prescription (if you received one)
• Insurance card(s)
• Driver's license or other form of identification
  • For minors: ID of parent or legal guardian is required
• Appropriate clothing and footwear (for example: t-shirt, shorts, tank top, sneakers, etc.)