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Patient Forms & Policies

New Patient Form

At your first visit, you will be asked to complete this form. If you are able to, you can save time by printing and completing this form before you arrive.

Additional Patient Forms

Discounted Payment Plan
For patients who are interested in applying for our Sliding Fee discount program. Learn more here.

Medical Records
For patients who would like to authorize the release of their medical records to a third party or individual.

Patient Complaint Form
For patients (or their representatives) who would like to document a patient concern regarding the health care or treatment that was received or not received.

Patient Grievance Form
For patients (or their representatives) who would like to report a patient concern that has not yet been resolved by present staff or requires further action for resolution.


Be an informed health care consumer. When you know our policies, you can make the most of your appointments and more effectively manage your health care.