Forms & Policies

Printable Forms:

• Provider Referral Guide – English
• Patient Registration Form – English | Spanish
• Request Medical Records – English | Spanish
• Authorization to Release Medical/Financial Information – English | Spanish
• Request to Inspect or Obtain Copy of Personal Health Information – English | Spanish
• Clinic Policies
  -  Patients Rights & Responsibilities – English | Spanish
  -  Privacy Statement (including HIPAA) – English
  -  Arbitration Agreement – English | Spanish
  -  Patient Billing Rights – English | Spanish

Online Forms:

• Make An Appointment
• Contact Us
• Patient Satisfaction Survey