- To shorten your wait time at your visit, print and complete the forms below and bring them with you:
- Medical history: This is a basic review of your health, including medical conditions and medications. Be as complete as possible.
- Registration Form: This form asks for basic information about you, your contact information, and your insurance.
- Notice of Privacy Practices: This notice describes how health information about you may be used and disclosed and how you can get access to this information.
- TCS: This is our service agreement form.
- Pre-visit checklist: Review this checklist for important things to bring to your visit.
- After Care Instructions – Surgical Termination: This is a copy of the instructions your doctor or the nurse will give you after your appointment.
- After Care Instructions – Medication Termination: This is a copy of the instructions your doctor or the nurse will give you after your appointment.
- Request for Personal Representative – Use this form to designate one or more persons as your personal representative(s) who can act on your behalf with respect to decisions involving the use and/or disclosure of your health information.