Patient Forms

If this is your initial visit to our office, please take time to fill out the intake forms in detail. Please complete both the patient registration form and the patient history form for your physician. This will allow the doctor to best understand your current problem in the context of your medical history.

Registration Forms

Patient Registration

Patient History Form - Dr. Palacio

Patient History Form - Dr. Miller

Patient History Form - Dr. Heindel

Patient History Form - Dr. Pallatroni

Patient History Form - Dr. Missios

Privacy Forms

Notice of Privacy Practices

Aviso Sobre las Practicas de Privacidad

These forms require Adobe Reader. If you do not have Adobe Reader, you may download it free here:

Get Acrobat Reader (this link opens a new browser window).