New Patient Information

If you are a new patient in our practice, please print out and complete the registration forms with an asterisk (*) below at your convenience before your visit. If you bring the completed forms with you, you will not have to waste time in the office filling them out (or be told to go back to your car during the pandemic because we are not allowing waiting in the waiting room).

The New Patient Forms has a few different parts within its six pages: the Insurance Authorization Form, which tells us who you are and what health insurance you have; the New-Patient Self Assessment, which summarizes your medical history and symptoms; the HIPAA Signature Page, which indicates that you have been given an opportunity to review our office’s privacy practices (this is the next file below); and the Informed Consent for E-mail Communication, which allows us to communicate with you via e-mail. You do not need to print out the Privacy Policy, it is for your information. If you agree to sign the e-mail communication authorization, we can send you private health information (such as test results and medical advice that you request) by email.

In addition, if you are being evaluated for sinus problems, snoring, sleep apnea, or headaches, please click here to go to our Questionnaires page, where you can download and fill out some additional forms that will help us better to assess your symptoms.

The Medical Records Release form is your authorization for us to release some or all of your medical records to either you or someone you designate, such as another physician.  Requests for release of medical records may take up to one week to be processed and sent to you or the recipient of your choice.