Forms

Patient Forms

To complete your paperwork, please click the link below. You will be asked to create an account. Please write down the user name and password that you create for future access to your records. Thank you.

Create Account / Fill Out Forms

Patient Portal

(Requires Internet Explorer)

Sharecare Records Request Form  / Front Desk Notice (PDF)

Insurances We Accept

Request for Restriction of Uses & Disclosures of PHI (Word)

Notice of Privacy Practices (PDF)

Authorization to Release Medical Records (PDF)