DON'T YOU JUST LOVE FORMS?

Established patients are patients that have been seen in our (medical) clinic at least once in the last 3 years. It is important for us to know any changes in your medical history since the last time that we saw you.  If it has been at least a year since your last visit, please complete the following forms and bring them with you to your next visit as it necessary to update these forms once yearly.

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HIPPA form

Interval medical history

Request of medical records (to be sent TO our clinic)

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We will need to confirm your current address, phone numbers and emergency contact information as well as a copy of your insurance card.