Online Patient Registration Forms
You may pre-register with our office by filling out our secure online Patient Registration Form. After you have completed the form, please make sure to press the Complete and Send button at the bottom to automatically send us your information. The security and privacy of your personal data is one of our primary concerns and we have taken every precaution to protect it.
After you have submitted your form, you will have the opportunity to securely upload and transmit an image of your medical or dental insurance card.
On your first visit to our office, we will have your completed form available for your signature. The security and privacy of your personal data is one of our primary concerns and we have taken every precaution to protect it.
HIPAA NOTICE OF PRIVACY PRACTICES
You will be asked to sign an acknowledgement that you have reviewed our “Notice of Privacy Practices for Protected Health Information” when you arrive in the office.
Please take time to review the Notice of Privacy Practices for Protected Health Information document.
