value. quality care. convenience |
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NEW PATIENT |
MEDICAL RELEASE |
FINANCIAL POLICY |
New Patient Registration Form - Required for all new patients. This form allows us to register you into our practice as well as provides us with a brief medical history of any problems you may be experiencing. Also attached is a copy of our privacy practices.
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Medical Records Release Form - Authorizes us to release your medical records to an individual or another doctor's office.
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Financial Policy and Insurance Requirements - Information related to established policies within our practice.
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CREDIT CARDS |
COUMADIN CONSENT |
DIAGNOSTICS INSTRUCTIONS |
Credit Card Pre-Authorization Form - Required to authorize recurring credit card charges or standard payments to the clinic.
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Consent for Warfarin (Coumadin®) Educational Material and Consent Form.
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NST Instruction Sheet - Important instructions that must be signed and returned to the clinic prior to any Nuclear Stress Test.
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