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Patient Forms

We know your time is valuable. Therefore listed below for your convenience are the New Patient Forms for you to print and complete prior to your appointment. Please bring these completed forms with you to your scheduled appointment and this will minimize your wait time in the office. If you are unable to have these completed prior to your appointment time, we ask that you arrive to the office at least 20 minutes early to allow the time needed to complete the paperwork. For all Newborn’s scheduled, please be sure and bring your hospital discharge folder/packet with you to your initial appointment.

Please be aware that if you are late for your appointment, you may be asked to reschedule. We cannot always work you back into the schedule on the same day due to the busy nature of the practice and the consideration of our other patient’s that do arrive at their scheduled time.

New Patient Packet
    PDF Document Demographic Page
PDF Document Patient Communication of Health Information
PDF Document Financial Responsibility Form
PDF Document HIPAA Acknowledgement
PDF Document New Patient Questionaire
PDF Document Notice of Privacy Practices
PDF Document PASR Office Policies
PDF Document PASR Vaccine Policy Statement
PDF Document Permission to Treat Form
PDF Document Authorization to Obtain Health Information
PDF Document Authorization to Release Health Information