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- Consent for Telemedicine Services Form
- New Patient Medical History
- Patient Information
- Appointment Cancellation
- Third Party Disclosure of Information
- Financial Policy
- Permission to Discuss Medical Information with Family Members
- Authorization for Use and Disclosure of Protected Health Information (PHI)
- Consent for the Use and Disclosure of Protected Health Information (PHI)
To obtain a copy of your medical records, please fill out the form below and return it to our office.