New Patient Forms

Each new patient will need to fill out the following forms for the first appointment. Please print them by clicking the link, fill them out, and bring them to the first appointment.

New Patient Form
Consent to Proceed

Click to read our Notice of Privacy Practices. Once read, print the following document to sign and bring with you to your first appointment, stating your acknowledgement of receiving our privacy practices.  Only one signed acknowledgement required per family.

Acknowledgement of Privacy Practices

If you are 16 years or older, please print and fill out this form:
Adult Health History

If you are 15 years or younger, please print and fill out this form:
Child Health History

Formularios En Español:

Español – Procedimiento para Proceder

Si tiene 16 años o mas, imprima por favor este formulario:
Español – Historia de Salud por Adulto

Si tiene 15 años o menos, imprima por favor este formulario:
Español – Historia de Salud por Niño

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