Please use black ink when completing all forms.

Acknowledgement of Privacy Practice

Financial Policies

Medical History Form

Patient Registration

Media Consent Form


Privacy Policy

Notice of Privacy Practices, contains the information that federal law requires us to give our patients regarding our privacy practices.

Click here to read the notice.

This notice is a pdf document, which requires the Adobe Reader software. You most likely have this software on your computer. However, should you have difficulty reading this notice, please click here to install Acrobat Reader.


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