MINOR NEW PATIENT PACKET

Welcome to Our Practice

Services Available by Location

Sliding Fee Scale

HIPAA Notice of Privacy

FQHC Survey
 *

Health History Form *

Consent to Discuss & Accompany *

Consent for Treatment *

HIXNY Consent Form *

HealthEConnections Consent Form *

Telehealth Consent Form *


 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Forms marked with a * are required to be filled out prior to your visit.