Annual Medicare Wellness Questionnaire
This form can be completed prior to your scheduled exam.
DownloadConsent to Treat a Minor
Allows someone other than the legal guardian to consent to treatment of the minor.
DownloadFMLA
There is a $20 fee for completion of all FMLA forms and we require 5 business days for completion.
DownloadMedical Records Release
Allows the patient to release medical records to another physician or obtain records from a previous physician.
DownloadPatient Communication Authorization
Allows permission to disclose information for care & notification purposes to other individuals i.e. spouse, friend, children, significant other.
DownloadPatient SMS Authorization
Allows permission to send messages via text directly to your cell phone for normal lab results, refill confirmations, billing correspondence, and appointment information.
Download