Forms

Please complete and bring the forms in the New Patient Packet when you come to your first appointment.

Forms for New Patients

• Authorization for Use or Disclosure of Protected Health Information ( for patients switching from another doctor )
• Registration Form for Pediatric Patients
• Consent To Treat

School Forms

• Physician’s Report – Child Care Centers (For Day Care and Preschool) 
• Health Examination for School Entry (for Kindergarten and School Age)