forms example

Authorization to Patient Access Information

Consent and Acknowledgement of Treatment and Services

HIPAA Notice of Privacy Practices

Medicare Advance Beneficiary Notice

Non-Participating/Self Pay Non-Emergent Services/Surprise Waiver Bill

Primary Care Physical Exam Charge Acknoledgement

Release of Information


In observance of Memorial Day our clinics and offices will be closed on Monday, May 29th.

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