If you are a new patient to our office, the attached file contains our new patient bundle with forms that will need to be filled out when you arrive at our office. Printing them, filling them out and bringing them with you will allow us to attend to your medical needs more quickly than completing them upon your arrival. Thank you and please call our office if you have any questions at all.
Patient Forms (Print & Complete All Forms Prior To First Office Visit)
Patient Medical History: MHpg1.pdf
Patient Medical History 2: Medical page 2.docx
HIPPA: Hipaa Disclosure consent.doc
Financial Policy: financial policy apple blossom.docx
Cancellation/No Show: cancellationandnoshow.docx
X-RAY Release Form: x-ray release form.doc
The following form only needs to be completed if a child will be brought to an appointment by someone other than a legal guardian that is at least 18 years of age:
Treatment without guardian consent form.docx
This web site uses files in Adobe Acrobat Portable Document Format (pdf) which require Adobe® Acrobat® Reader for viewing and printing. It is available to download free.