Forms

Required Forms

Please print and bring all completed forms to your appointment.

Registration Registration - Spanish Health History Health History - Spanish Financial Policy Financial Policy - Spanish Privacy Notice Consent Privacy Notice Consent - Spanish

Informational Forms

The following forms are for information only and do not need to be printed or brought to your appointment.

Privacy Notice Medical Records Release Medical Records Release - SPANISH GOOD FAITH ESTIMATE Nondiscrimination and Accessibility Requirements

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Good Faith Estimate

You have the right to receive a “Good Faith Estimate” explaining how much your medical care will cost.