Patient Forms
Have you checked your Follow My Health portal?
For the most seamless experience, it is highly preferred that you complete these administrative forms directly through the Follow My Health link sent to your phone or email. If you did not receive a portal link or prefer direct submission, you may utilize the secure alternative links below.
English Intake Forms
Please select, review, and fill out the appropriate validation documents below prior to your clinical appointment:
- Medical History Information Form For adult patients (Ages 18 years and older)
- Pediatric Medical History Info Form For minor dependents (Under 18 years of age)
- Notice of Privacy Practices & Policies Standard compliance disclosure paperwork
Commercial Insurance Patients:
Patients with non-government, commercial plans must file an authorized payment source.
Credit Card Authorization Form View Policy DetailsFormularios en Español
Por favor, seleccione, revise y complete los documentos de validación requeridos antes de su consulta clínica:
- Formulario de Historia Médica Para pacientes adultos (18 años de edad o más)
- Historia Médica Pediátrica Para dependientes menores (Menores de 18 años)
- Aviso de Prácticas de Privacidad y Pólizas Documentación obligatoria sobre la divulgación y cumplimiento
Pacientes con Seguro Comercial:
Los pacientes con planes comerciales (no gubernamentales) deben registrar un método de pago autorizado.
Autorización de Tarjeta de Crédito Ver Detalles de la Póliza