if you have insuance

patient information sheet

patient medical release form (if you wish anyone else other than yourself to receive information from this clinic about you like your spouse, childern, etc) - unless you have already filled it out

assignment of benefits (so we can bill your insurance)

Financial responsibility - unless you have already filled it out

Patient initiated complaint form (so we can contact the insurance company and the board of insurance if your insurance fails to pay on your behalf) **Note you must fill out 2 of these forms - unless you have already filled it out for your current ins co

 

if you do not have ins

est pat info sheet