Patient Forms

Acknowledgement: Receipt of Privacy Practices

Authorization for Care to Minor(s)

Authorization for Release of Medical Records

Authorization to Share Medical Information

Medical History

Medical Liability

Notice of Privacy Practices

Patient Demographics

Prescription Refill Process

Acknowledgment: Patient Rights & Responsibilities

Health Information Privacy Complaint

Complete New Patient Paperwork Online

Are You an Existing Member or Current Patient?

If you are experiencing  a medical emergency, please call 911 immediately or go to the nearest emergency room. 

A representative will respond within 1-2 business days.