FORMS

Please complete the Pre-Surgery Questionnaire prior to your appointment. Don't forget to print the completed form and bring it to your appointment. (For pre-surgical patients only)

This Medical Records Release Form is used to request records from one of our physicians. The records will be forwarded to the individual you specify on the form. (Please be aware, you could incur a copy fee for this request)

This notice describes how medical information about you may be used and disclosed and how you can get access to this information.

Medical Records Release Form II is used to request records from a physician outside of our office. Per this release form, the records will be forwarded to our office. (Charges, if any, for this service are determined by the providing office)

The Reverse Opt-Out Form should be completed if you wish to retract a previously completed Opt-Out Form.

The Opt-Out Form should be completed if you choose NOT to allow other participating medical facilities access to your records for medical treatment.