New Patient Forms

Parents or guardians: please complete the form on the next two pages.

You may also like to have your child fill out the Kid’s Questionnaire to help our staff get to know them better.

Kids Questionnaire

HIPPA Forms

In addition to the online application below, to save time at the office, please print out and bring your HIPPA Consent Form, available in Spanish or English.
HIPAA Consent Form(eng)

HIPAA Consent Form(span)

Financial Policies:

2016 Financial Policy  (English & Spanish)

ONLINE NEW MEMBER FORM

Please fill one out for each child.