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 & Non-Discrimination Disclosure Notice – Please review these policies, then print and sign the acknowledgment form and bring it to your appointment.

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

Non-Discrimination Disclosure Notice

Acknowledgment of Privacy and Non-Discrimination 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 Receive Mobile Communications - English