New Patients
Welcome!
Please fill out and print these forms and bring them to your first appointment:
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Patient Registration and Information (English Version) (PDF)
- Patient Registration and Information (Russian Version) (PDF)
- Patient Registration and Information (Spanish Version) (PDF)
- Notice of Privacy Practices
PDF files require Adobe Reader to view. If you do not have Adobe Reader installed you can download it here.
Please assist us by bringing the following information to your first appointment:
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All three completed & signed registration forms above
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Current medical insurance card
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Insurance co-pay, or Self-Pay co-pay (due at time of service)
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A list of medications you are currently taking
IMPORTANT: All patients under the age of 18 years of age must be accompanied by a parent or guardian at first visit.