Notice of Privacy Practices

This notice describes how we use and protect your personal health information.

Consent to Treat Minor

This form gives a provider permission to treat your child when he or she is in someone else's care.

Medical Records Release

Authorize the release of full and complete protected medical information to a requiring entity

Patient Portal Terms of Use

Policy and Procedures on use of the patient portal.

Patient Portal Consent Form

Consent to sign accepting the patient portal terms of use, as well as providing an up-to-date email address.

OB Financial Agreement

This form is the OB Financial Agreement Explanation Sheet

Vehicle Accident Report Form

Fill this form out before your appointment to cover the details of your accident. 

Sports Physical Form

Fill this form out before your physical examination.

We are dedicated to providing you the most current and up-to-date information regarding your privacy and changes in our practice. Please use these forms to update us when any of your demographic information changes. This will help keep the information in your chart current.