Forms

Prior to your visit, you will complete—and then bring with you to your first appointment—several forms

Once you schedule, we will send these required forms to you via email, or you may download selected forms (below) and get started.

Insurance Verification Form
The insurance verification form (which you may download here) is the form you will you use to make sure you collect needed information when you call your provider to verify your insurance coverage (e.g. providers and services that are covered in and out of network, deductibles, number of visit limitations, etc.).    Please bring this completed form to your first appointment.

Patient Intake Form
The patient intake form (which you may download here) helps you to provide us with contact information as well as your current and historical general health and wellness.  It gives us a broad overview and a starting point for getting to know you and your health care needs.   Please bring this completed form to your first appointment.

 

Consent Forms

When you schedule, the following consent forms will be sent to you via email. If you would like to download and read the Clinic policies and HIPAA Privacy Practices, you can do via the link below. If you are seeing a provider via telemedicine, please make sure you have read and signed the signature form before your appointment. This will confirm that you have read, reviewed and understand all notices of our policies and practices.