New patient registration forms

Click on the link above to download the registration packet (in PDF format), which includes:

• New patient registration form
• Health history form
• Notice of health information privacy rights under HIPAA
• Notice of financial policies
• Notice of concierge services policy
• Guide to calling your insurance company

Please bring the completed forms with you to your first visit. Alternatively, you may use the “autofill” option on your PDF-viewing application to complete digitally, and send in before your appointment by fax or email (see contact information). If sending by email, you may wish to encrypt the file with a password of your choosing for greater security of your personal health information. 

You can access a brochure of your privacy rights online from the U.S. Department of Health and Human Services.