Patient Forms

Patient Forms

Patient Forms

Our office moved to a new Electronic Health Record system, Modernizing Medicine, in March of 2020. This new platform allows us to become a (mostly) paperless office, and we are excited to offer you an easy, interactive, electronic way to keep your information updated. When you make an appointment with our office, you will be sent an email invitation to our Modernizing Medicine Patient Portal. From there you are able to update all of your personal, insurance and health history information prior to coming to the office. You can also securely communicate with our staff for most of your questions (appointment availability, medication refills, test orders, etc.) When you arrive for your appointment, you will be given an iPad kiosk and you will electronically sign standard intake documents as well as double check your previously entered information. This process should not take more than 5 minutes.

If you do not have an email address, or access to a computer or smartphone at home, it’s okay! We just ask that you arrive 30 minutes prior to your appointment time to complete your information on our easy kiosk!

Be sure to bring your insurance card(s), photo identification and a current list of medications to your appointment.

New Patient Forms

If we are treating your minor dependent and you might have another person accompany them, we ask that you complete this form and bring it to your visit. Remember, we cannot and will not treat a minor without an accompanying responsible adult.

If you are needing medical records sent to our office, or from our office to another provider, please complete this form. It must be signed by the adult patient or the minor patient’s responsible guardian, unless you can provide a Power of Attorney. You can mail, fax or email it to us.

Authority to Treat Minors
Authority to Treat Minors – Español