Forms & Handouts

First Visit

For your convenience the following forms are available for printing and completion. To reduce the paperwork required during your first visit you can fill out the forms below, at your convenience, before arriving. Please either print the blank forms and fill them out by hand, or simply fill out the forms electronically while online and then print your completed forms (clicking on the editable areas of the form will allow you to fill in your information). Additionally, forms describing our current Office Policies are included below. After completing the forms in one of the outlined methods, please bring the Family Information Sheet, Medical Questionnaire, and HIPAA Acknowledgement Form with you on your first visit for office processing and mail the Record Release form for Incoming Records to your previous physician's office to request that your child's records be sent to our office.  If you wish to transfer your records to another office, there is also a Record Release Form for Outgoing Records.
Viewing the forms requires Adobe Acrobat Reader, available for free from the link at the bottom of this page.  If you are using an older version of Adobe Acrobat Reader, forms created using a newer version may give an error message.  If this is the case, please download and install the latest version using the link below.

Office Policy Forms

• Financial Policy
• Notice of Privacy Practices
• Patient's HIPAA Acknowledgement
• Missed Appointments Policy

First Visit Forms

• Family Information Sheet
• Medical Questionaire
• Record Release Form - Incoming Records