Welcome to Patient Registration

Our patient registration forms are available to download. Please feel free to print them out and either mail them to us or bring them with you at your appointment date. This will help expedite your registration process at the time of your scheduled appointment. There are two pages to the  Registration form. All information must be complete. Our Financial Policy and Prescription Medical Policy are accessible for you to read.  Your electronic signature will be required at the time of your visit acknowledging these policies, as well as the HIPPA privacy forms.  Be prepared to complete a Patient Health History when you arrive for your visit.  A copy is shown for your perusal.

Please provide the receptionist with all insurance cards on the day of your visit as well as, your Photo ID.

If you must have someone other than a parent or guardian accompany your child (18 years and younger) to see our physicians, please complete the Parental Authorization Form for our records.

Should your insurance plan require a referral to our office, you will be responsible for obtaining a current referral at the time of your office visit. Due to insurance requirements we will be unable to see you or your child without a referral and you may be required to reschedule the office visit.

Included in the Privacy Information Section of our website you will be able to access, read, and print our Notice of Privacy Practices as well as the Consent Form.

We hope that you find this information easily accessible and helpful. Feel free to call us if you have any questions regarding this information.

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