Forms and Documents

Authorization to Release Medical Information Form (click here)

HIPAA form to view: Notice of Privacy Practices (click here)

HIPAA form to print: HIPAA Acknowledgement and Consent Form (click here)

Financial Policy (click here)

Patient Registration and Questionnaire (click here)

Cancellation and rescheduling fees: You may be charged a $50 cancellation/reschedule fee if you cancel or reschedule your appointment or procedure less than 48 business hours in advance.

No show fees: You may be charged $50 for not showing for your office visit or procedure.