Patient Services Agreement & Office Policies

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    HIPAA (Privacy) Information and Signature Page

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    Patient Information Form—Adult (18 or older)

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

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    Payment Information Form

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    No Surprises Act (NSA) Patient Qualification Information

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    Authorization to Release Patient Information

 

     

    Telehealth via Video Conferencing Agreement

 

 

    Directions and Parking