|
|
| Please take the time to read and sign our HIPAA Notice of Privacy Practices and complete the Patient Registration Form, and online Patient Health History Form. The online Patient Health History Forms provide a convenient and easy way for you to complete intake paperwork prior to visiting the physician's office. Upon submission, your answers can be reviewed by the physician and then imported directly into your records.
|
| The Patient Health History Form, Patient Registration Form, and Universal Consent are required for your first visit. You do not need to complete both the online and printable Patient Health History. Please choose whichever version you prefer.
|
|
|
|
|
|
|
|
Required
- Drivers License
- Insurance Card
- Patient Health History Form
- Patient Registration Form
- Universal Consent Form
Optional
Bring all that apply
- X-rays
(including any from the ER)
- Cat Scans
- MRIs
- Lab Results
- Referral from your primary care physician
Worker's Compensation
- Employer Information
(name, address, phone number)
- Worker’s Compensation Insurance Information
(company’s address, phone number, contact person, and the claim number)
|
|
|