Patient Forms

The following are office forms which may be downloaded and filled out prior to an office visit. For new patients there are registration forms and record release forms. For patients with physicals there are forms for your health history. These are helpful to have filled out prior to your visit.

(Health Insurance Portability and Accountability Act of 1996)
The Health Insurance Portability and Accountability Act of 1996 (HIPAA) office Notice of Privacy is below. This is also available in our waiting room for review.

Primary Care First (PCF)
The Primary Care First (PCF) is an innovative trial program developed by CMS to test improved patient care models with a payment model to help reimburse preventive care as well as coordinating patient care. For full information on the  Primary Care First clink on the link ” PCF

  • CMS PCF Explanation Letter: PDF
  • Decline Participation with CPC+ Form: PDF
  • Change in Participation Status with CPC+ Form: PDF