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How to Save Time by Preparing for Your Visit

Be at your appointment 30 minutes early (to fill out forms)
OR
Print and fill out these forms and be at your appointment JUST 5 MINUTES prior to your scheduled appointment.

 

The Document

What To Do

1. Our Privacy Practices

  

Please read prior to your visit.

 

2. Receipt of our privacy practices
or
Acuse de recibo de la Notificatión subre prácticas relacionadas con la privacidad

 

  

Please sign to acknowledge that you have read our privacy practices, and bring the form with you.

3. Insurance Information Form or
Seguro Authorizartion Y Aisgnación

  

Please fill out this form and bring it with you.

 

4. Health Questionnaire or
Cuestionario De Salud

 

Please fill out this form and bring it with you.

 

5. Arbitration Agreement or
Convenio de Arbitraje

  

This form must be signed at the office.

 

6. Pregnancy Questionnaire

  

Please complete this document if you are here to discuss your pregnancy, and bring the form with you.
     

*If you are unable to open the documents by clicking on them,
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Teki Hegwood, MD