Patient Forms

Your Care

Fill out online or print

For your convenience, clicking on the links below will display a printable PDF file that can be filled out online and printed or downloaded, filled out and printed prior to your visit. (Requires free Adobe Acrobat Reader application)

Your Care Patient Intake Forms

Patient Intake-Demographic

Patient Intake-HIPAA Release Form

Patient Intake-General and Financial Policy

Medical Records Release Form

DOT Physical Intake Forms

DOT Physical Policy

DOT-Epworth Sleepiness Scale

For Your Information

HIPAA - Notice of Privacy Practices, English

HIPAA - Notice of Privacy Practices, Spanish