Miscellaneous Forms

 

Below are two forms that you will be asked to complete upon arrival to our clinic for your child's first appointment.  Please feel free to print and complete the forms in advance and bring with you to your child's appointment.

 

New Patient Information Sheet
HIPAA Receipt of Notice of Privacy Practices

 

HIPAA Notice of Privacy Practices
(You do not have to bring this form with you.  It is for information purposes.)