PDF Files Available for Download
- New Patient Packet (PDF)
- Notice of Privacy Practice (PDF)
- Authorization to Disclose Protected Health Information (PDF)
COMPLETING, PRINTING AND/OR SAVE SCREEN FILLABLE PDF FORMS
Some of the forms on this site are “fillable” on your computer. This means that you can conveniently complete such form right on your computer by simply typing information into a form’s displayed fields.
Selecting the blue-colored buttons labeled “New Patient Packet” or “Authorization to Disclose Protected Health Information” will open our PDF filler option. This electronic option enables patients to fill, sign, and directly send all documents to our practice. Patients will have the option to print or email their completed copies to themselves.
We also have the “New Patient Packet” or “Authorization to Disclose Protected Health Information” in a downloadable PDF format that can be filled in by typing in the displayed fields; however, certain fields can only be filled out once the form is printed. Patient’s can print their forms to a printer, sign the designated locations in ink, and either scan and email or mail the forms to our location.
The filled out and scanned forms can be sent to firstname.lastname@example.org