Please complete your patient registration forms in advance. When you arrive at our office, present these completed form along with your insurance card and one form of identification to the receptionist.
New Patient Paperwork
- Registration Form.pdf
131K Download
- New Patient Worksheet.pdf
106K Download
- Financial Responsibility and Privacy Acknowledgement.pdf
102K Download
- HIPAA Medical Records Release Authorization Form
86.5K Download
Privacy and HIPAA Notices
- HIPAA Notice Brochure.pdf
109K Download
- HIPAA Protected Health Information Disclosure
59K Download
Other Forms
- Physician Business Interest Disclosure.pdf
54K Download
- Men's BPH Symptom Score.pdf
70K Download
Have a question? Call us at: (806) 771-0077