· Patient Registration Form  (1 page)

 

· Consent to Release PHI to Family (1 page)

 

· Consent for Treatment, Payment and Healthcare Operations  ( 1 page)

 

· Financial and Payment Policy with Assignment Release  (2 pages)

 

· Health History Form/Review of Systems  (2 pages)

 

· Prostate Health (For Men Only)  (1 page)

 

· Notice of Privacy Practices ( For Your Records Only)  (4 pages)

 

· Request For Medical Records To Be Sent To Us (1 page For Each Physician)

 

· Self Pay Agreement  (1 page)

 

· Financial Hardship Application   (2 pages)

 

    Annual Updates

 

· Consent to Release PHI to Family (1 page)

 

· Consent for Treatment, Payment and Healthcare Operations  (1 page)

 

· Financial and Payment Policy with Assignment Release   (2 pages)

 

· Health History Form/Review of Systems  (2 pages)

 

· Prostate Health (For Men Only)   (1 page)

 

· Self Pay Agreement  (1 page)

 

· Financial Hardship Application  (2 pages)