Forms

To ensure the best experience with our medical clinics, we encourage our patients to complete forms in advance of their visit. This helps to keep appointments running smoothly and to get the correct information to providers, so they can provide the best possible care for patients.

Forms for Medical Record Information
Autorizacion Para Entregar Historial Medico

Receiving Records: English

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Receiving Records: Spanish

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Releasing Records: English

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Releasing Records: Spanish

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Dental Forms

Patient Registration Form – English

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Formulario de Registro – Español

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HIPAA Notice of Privacy Practices

Privacy Practices Form

Download pdf

Patient Complaint Form

Complaint Form

Here

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