New Patient Forms
For your convenience, you may fill out all the required forms prior to coming into our office. Save some time for yourself!
All new patients need to read and sign the HIPAA Notice of Privacy Practices
Cash Patients need to read and complete all of the following forms:
Patient Information
Patient Symptoms
MVA Patients need to read and complete all of the following forms:
Patient Information
Patient Symptoms
Auto Accident Information
Insurance Information
Lien Agreement
Healthcare Power of Attorney
Attorney Distribution Authorization
Assignment of Benefits For Direct Payment to Doctor
Disclosure of Fee's / Payment Policy
After completion of all forms and paperwork, please bring them in with you when you come to our Aim High Office.
For forms you do not fully understand, feel free to bring it in and our CA will explain everything to you.
|
