Please print and complete each form as indicated and bring with you to your consultation. Thank you!

File Name Size(KB) Modified Uploaded By Authorization-for-release.pdf 36 5/19/2010 3:20:36 PM    hporter Financial-Responsibility.pdf 17 5/19/2010 3:20:36 PM    hporter Notice-of-Privacy-Practice.pdf 29 5/19/2010 3:20:36 PM    hporter Patient-Consent-for-use-and-disclosure.pdf 14 5/19/2010 3:20:36 PM    hporter PATIENT-INFO-SHEET-021008.pdf 48 5/19/2010 3:20:36 PM    hporter Patient-Pharmacy-Info.pdf 10 5/19/2010 3:20:36 PM    hporter

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