Patient Forms & Privacy Notice

Please fill out the forms below and bring them with you when you come for your visit.

Patient Forms

Registration and Consent Form

Return Visit

• Shot Check List
• Shot Check List (Español)
• Pill Check List
• Pill Check List (Español)

Privacy Notice

This privacy notice describes how health information about you may be used and disclosed and how you can get access to this information. Please review it carefully.
Notice of Privacy Practices