Forms have been made available to you on this website for your convenience. Whether you are an individual preparing your documents prior to your appointment or a business looking for a bit more company oriented form, all those are available here for you to print.
Choose the category that best describes you or your need and click on the link to take you to the appropriate forms you may need. Please ensure that the forms are as complete as possible for a much more efficient check-in process when you arrive at the clinic.
New Patient forms
For business related form, please click here.
If you were a patient that has been seen at this clinic in the past, but has not been back or seen by one of our providers in the last two (2) years, you will need to complete the forms designated to the "New Patients" as a lot may have changed since your last visit with us. For those who are established, the following must be completed.
- Patient Demographics Form - must be completed if changes have occurred regarding your status, addresses or phone number, employer and insurance information. This form must reflect the most up to date information about you.
- Financial Policy Form - this form is require once every two years only.
- Intake Form (2-9 years of age)/Intake Form (10+ age) - the intake form must be completed each time you visit the clinic, or once every week if consecutive visits at the clinic have occurred.
- Sliding Scale Form (only if applying or reapplying)