Before filling out our forms, we recommend that you download the forms to your computer and save the file. If you open the forms online and complete them without downloading or saving to your own computer, we will receive a blank form. For ease of service, we recommend using Google Chrome when downloading our forms.
If you are unable to send us these forms online, please print them and fax them to use at 866-644-6363 or scan them and email them to us.
We ask that you send these forms to us at least 24 hours prior to your visit and seek confirmation from us that we have received them.
Please be aware that if you are a new patient and we do not receive a full complete history intake, contact information, and any other required forms within 24 hours of your scheduled appointment, you may be asked to reschedule.
- Female History Intake or Male History Intake
- Contact Information
- Release of Records
- Notice of Privacy Practices
- Acknowledgement of Receipt of Privacy Practices
- Letter of Understanding ERX
- Informed Consent
- Physician/Patient Arbitration Agreement
- Credit Card Authorization Form