Provides information about practice hours, sick appointments, walk-ins, patient balances, telemedicine, co-pays, self pay, mail order prescriptions, referrals, cancellations, insurance change, and other important information. Please make sure to read this.
Allows patients to authorize the disclosure of their health information to a designated individual, company, agency, or facility.
All patients must provide their consent for treatment, communications (calls, emails, and text messaging), and agreement of financial responsibility.
Patients are encouraged to complete and return the Preferred Contacts Form but it is not required.
We ask that all new patients complete this form and either email, fax, or bring with you on the day of your appointment.