Printable Office Forms
Prior to your appointment, the forms listed below can be printed for your convenience. Filling them out beforehand will save you time by not having to complete them during your appointment. If you elect not to fill out these forms ahead of time, please arrive 15 minutes prior to your scheduled time. (You may download Adobe Reader for free at www.adobe.com.)
Patient Forms
- Authorization for Release of Medical Information (PDF) - Allows patients to authorize the disclosure of their health information to a designated individual, company, agency, or facility
- Autorización De HIPAA Para Divulgar Información Del Paciente (PDF)
- Authorization and Consent for Treatment (PDF) - All patients must provide their consent for treatment, communications (calls, emails, and text messaging), and agreement of financial responsibility
- Autorización y Consentimiento Para el Tratamiento (PDF)
- Preferred Contacts (PDF) - Patients are encouraged to complete and return the Preferred Contacts Form but it is not required
- Contactos Preferidos (PDF)
- Virtual Visit Policy (PDF) - This policy describes the process for the documentation, maintenance, and transmission of information using virtual visit technology
Additional Patient Forms
Forms can be completed online through the patient portal or you can print them from our website and bring them with you to your appointment.
Behavioral Health Forms
Well Check Forms
