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Office Forms & Information

    Patient Services Agreement & Office Policies


    HIPAA (Privacy) Information and Signature Page


    Patient Information Form—Adult (18 or older)


    Patient Information Form—Child/Adolescent (17 or younger)

    Payment Information Form

    No Surprises Act (NSA) Patient Qualification Information


    Authorization to Release Patient Information



    Telehealth via Video Conferencing Agreement



    Directions and Parking

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