FORM 01 · PDF · 11 PAGES
New Patient Package
First-visit paperwork, health history, medications, and insurance information.
HERE TO MAKE YOUR VISIT EASIER
Patient resources, all in one place.
Everything you need to prepare for your appointment, organized in one simple, easy-to-use location.
FORMS & PAPERWORK
Prepare for your visit
All eight patient forms are ready. Choose “View PDF” to read a form on your device, or “Download” to save and print a copy.
FORM 02 · PDF · 1 PAGE
Release of Medical Records
Authorize the release of specified information from your medical records.
FORM 03 · PDF · 1 PAGE
Consent to Release Verbal Confidential Information
Choose who may receive your medical information by phone or in person.
FORM 04 · PDF · 1 PAGE
Privacy Practices Acknowledgment & Consent
Acknowledge receipt of privacy information and sign the related consent form.
FORM 05 · PDF · 1 PAGE
Changes in Personal Information
Update your address, phone, insurance, pharmacy, or other information.
FORM 06 · PDF · 1 PAGE
Patient Self-Determination Form
Document whether you have an advance directive or healthcare surrogate.
FORM 07 · PDF · 1 PAGE
Comprehensive Pain Assessment
Describe your pain, its intensity, medications, and effects on daily life.
FORM 08 · PDF · 1 PAGE
Geriatric Depression Scale
A 15-question form about how you have felt over the past week.
Before your visit: Download or print the forms you need, fill them out, and bring them to your appointment. Some forms ask for private medical or personal details. Do not email completed forms or submit sensitive information through this website. Please call our team if you need assistance.
Need help with your paperwork?
We are happy to answer questions about which forms you need for your visit.