Patient Forms

REQUIRED NOTICES

Postings required by Health Insurance Portability & Accountability Act (HIPAA) and Health Information Technology for Economic and Clinical Health Act (HITECH):
NOTICE OF PRIVACY PRACTICES

Postings required by the U.S. Department of Health and Human Services:

NON-DISCRIMINATION & ACCESSIBILITY NOTICE

NOTICE OF AVAILABLE LANGUAGE SERVICES & AVAILABLE AUXILIARY AIDS

Forms to print (optional) – we will provide this at your first visit if you don’t print it:

BODY PAIN DIAGRAM