Forms

New patient paperwork is a crucial part of the healthcare process. It includes several important documents such as HIPAA, financial policy, vaccination policy, and terms and conditions. HIPAA ensures the privacy security of patient information, while the financial policy outlines payment expectations. The vaccination policy explains the importance of vaccinations, and the terms and conditions provide important information about the patient's rights and responsibilities. It's important to carefully review and complete all of these documents to ensure a smooth and successful healthcare experience.

A medical record release is a document that authorizes the disclosure of a patient's medical information to a third party. This can include medical history, test results, diagnoses, and treatment plans. The release is typically signed by the patient or their legal representative and is required by law to protect patient privacy.

A TB Risk Assessment is used as a guide to determine if your child needs a TB test. These forms are used around the time your child begins school/daycare. Please answer the YES/NO questions before giving the form to your provider to sign.

The only documentation regarding your health or illness required by law (and included in the office visit charge) is an office visit note.

Completing paperwork for schools, camps, long-term care, life insurance, or other purposes is duplication and goes beyond routine medical care. Therefore, it cannot be billed to your insurance company. Since all forms require our signature, we are personally responsible for the accuracy of the information provided.

Therefore, it is our office policy to charge for the completion of any form as follows:

-Completion fee of $10 per form

-Copies of immunization records- $10 charge.