Please print and fill out forms and BRING WITH YOU ON YOUR FIRST VISIT. PLEASE REMEMBER TO BRING YOUR INSURANCE CARD, YOUR CHILD'S IMMUNIZATION RECORD AND ANY CO-PAY, SHOULD YOU HAVE ONE.
hippa.pdf | |
File Size: | 210 kb |
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If you have a foster child | |
File Size: | 260 kb |
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authorization_to_disclose_info.pdf | |
File Size: | 366 kb |
File Type: |
patient_disclosure.pdf | |
File Size: | 206 kb |
File Type: |
new_demo.pdf | |
File Size: | 334 kb |
File Type: |
new_consents.pdf | |
File Size: | 310 kb |
File Type: |