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As a new patient visiting our office for the first time, please
print each of these forms, fill them out and bring them with you to your first
office visit. Also, if you have any current x-rays, please bring those as well.
Some of these forms are in PDF format. You will need Adobe Reader to
open these files. If you don't have Adobe Acrobat? Click below for a free
download!
Adobe Reader - This software
download is available without charge from Adobe Systems, Inc. The "Acrobat
Reader" allows you to view and print Portable Document Files (PDF) like the
downloadable documents available from this web site. Once Acrobat is installed
on your PC, you will be able to read all PDF files that you encounter on the
Web. Follow the link at the beginning of this paragraph to download your free
copy of Adobe Acrobat.
New Patient Information
Confidential Patient Case History
Payment Agreement
Records Release & Payment Authorization
HIPAA Document
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Insurance Information |
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Our services are covered by most insurance providers as out-of-network benefits.
Coverage varies by policy, so please check with your insurance
provider for your policy's covered benefits.
As a courtesy, we process your insurance claims.
We are United Healthcare Providers. |
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