Patient Forms & Fees
New Patient Forms
Save time at your appointment by filling out your patient forms ahead of your visit. Click on the links below to view and print forms.
- Patient Registration Form
- Patient History Form
- Review of Systems
- Financial Policy
- Patient Record of Disclosures
- Patient Information Release
- Authorization to Treat Minor
- Physical Examination Form / Pre-Operative Examination Form
- Patient Rights & Responsibilities
- Notice of Privacy Practices
Completing Forms for Our Patients
We are pleased to assist our patients by filling out any necessary medical forms in a timely manner, including:
- Disability forms
- Family and Medical Leave Act (FMLA) forms
- Insurance forms
- School, sports and camp forms
Please note that there will be a charge to have forms filled out based on form length, as follows:
- Each form less than 4 pages: $15
- Each form that is 4 pages or more: $25
Completion of forms typically takes 3 to 4 business days. For more information, please call our office at 818-382-6400 or contact us today.