Forms

Welcome packet – This should be filled out by all new patients and all existing patients every 12 months. If you are not sure if you should fill this out, please print and bring it with you.

Adult Welcome Packet - English
Adult Welcome Packet - Spanish
Child Welcome Packet - English
Child Welcome Packet - Spanish

Acknowledgment of Notice of Privacy Policy – Please review the policy, then print and sign the acknowledgment form and bring it to your appointment.

Notice of Privacy Policy - English
Notice of Privacy Policy - Spanish

Acknowledgment of Privacy Policy - English/Spanish

Consent to Recieve Mobile Communications – Please review the document, if applicable, then print and sign the acknowledgment form and bring it to your appointment.

Consent to Recieve Mobile Communications - English

 

Please Note:
All new minor patients must be brought to their appointment by a parent or legal guardian. The parent or legal guardian must be the individual completing and providing our staff with all required forms. After the initial appointment, authorized individual may accompany the minor.