New Patients

To help expedite the check-in process, please print and fill out the following forms prior to your first appointment:

English Versions

  • New Patient Questionnaire

https://documentcloud.adobe.com/link/review?uri=urn:aaid:scds:US:4f527ffd-55dc-452a-962f-502979543c75

  • Email Consent Form/Patient Portal

https://documentcloud.adobe.com/link/review?uri=urn:aaid:scds:US:88abd4eb-9d2c-4851-b392-b343362cd13e

  • Insurance Consent Form

https://documentcloud.adobe.com/link/review?uri=urn:aaid:scds:US:1f9dfadd-bf85-4c87-b457-a1d88bf202c8

  • Patient Certification and Verification

https://documentcloud.adobe.com/link/review?uri=urn:aaid:scds:US:23cb710b-606c-4961-8b16-662f4ab40841

  • Protected Health Information (PHI) / HIPAA

https://documentcloud.adobe.com/link/review?uri=urn:aaid:scds:US:3450ddeb-4c4d-4fc6-b844-6521750dfd84

  • Telehealth Consent

https://documentcloud.adobe.com/link/review?uri=urn:aaid:scds:US:1253f246-8022-4efa-bfac-ab1e456112a8

  • New Patient Information Form: Will be completed at the office at your first visit

Versiones en español

  • CUESTIONARIO PARA PACIENTES

https://documentcloud.adobe.com/link/review?uri=urn:aaid:scds:US:68af7fa3-8d39-448c-b4f0-e59188a95ba3

  • Formulario de consentimiento por correo electrónico

https://documentcloud.adobe.com/link/review?uri=urn:aaid:scds:US:830a0023-291b-48a7-9f26-16c38227e6b8

  • Formulario de consentimiento del seguro

https://documentcloud.adobe.com/link/review?uri=urn:aaid:scds:US:b0323b39-561a-4505-a250-1bafbec9b268

  • CERTIFICACIÓN DEL PACIENTE, AUTORIZACIÓN PARA DIVULGAR INFORMACIÓN Y SOLICITUD DE PAGO

https://documentcloud.adobe.com/link/review?uri=urn:aaid:scds:US:9705d91f-c8fd-4205-9722-132056b8975d

  • Información de salud protegida (PHI) / HIPAA

https://documentcloud.adobe.com/link/review?uri=urn:aaid:scds:US:aaf53744-6a90-464e-9033-81cdce67368f

  • Consentimiento para visitas “virtuales” de telesalud

https://documentcloud.adobe.com/link/review?uri=urn:aaid:scds:US:ce8e6f2c-b629-4eb9-9f71-9e0b921ac553

  • Formulario de información para pacientes nuevos: se completará en la oficina el primer día