Patient Forms
Download and print the required forms before your appointment. Bring completed forms to your visit.
Before Your Visit
- Print and complete the required forms before your appointment
- Bring completed forms to your appointment
- Do not email completed forms
- If you cannot print, arrive 15 minutes early
Required Before First Visit
All patients must complete these forms
New Patient Registration
Complete patient demographic and contact information
Consent to Treat
Authorization for medical treatment and care
HIPAA Notice of Privacy Practices Acknowledgment
Acknowledgment of privacy practices and patient rights
Financial Policy
Payment terms, insurance, and billing information
Release of Information (ROI)
Authorization to release medical records to third parties
Telehealth Consent
Agreement for virtual/telehealth appointments
Electronic Communication Consent
Acknowledgment of risks for text, email, and portal communication
AI Use Disclosure / AI Transparency Notice
Information about AI tools used in clinical care
Functional Medicine / Integrative Care Disclosure
Understanding of functional medicine approach and philosophy
Hormone & Men's Health (If Applicable)
Complete if you're pursuing hormone therapy or men's health services
Testosterone Therapy Informed Consent
Risks, benefits, and monitoring requirements for testosterone therapy
Fertility Disclosure Acknowledgment
Information about fertility considerations and family planning
Controlled Substance Agreement
Agreement regarding controlled substance prescribing
Lab Monitoring Acknowledgment
Understanding of baseline and follow-up lab testing requirements
Men's Health Program Agreement
Cash-pay terms and follow-up requirements for men's health services
Ready to Schedule?
Complete these forms and bring them to your appointment. If you have questions, call us at (985) 251-2562.
Book Your Appointment