Patient Information
If your first visit has been scheduled, please print out, read and complete all the forms listed below. By printing and completing these forms prior to your first visit, it can help us provide you with faster service.
For questions about any of the forms, please call our office at (405) 691-0505
All forms can be printed from your personal computer.
- Patient Information Forms – Information and Health History about you or the individual(s) that our office is seeing.
- Notice of Privacy Practices - How medical information about our patient may be used and disclosed and how to request this information. Please review this notice carefully.
- HIPPA Consent Form – This form states that the patient has read and received a copy of the office’s Notice of Privacy Practice and must be completed and signed prior to receiving medical services.
- Responsible Party Statement and Payment of Benefits – This form states the patient or the patients guardian is financially responsible for all charges that are not covered by the insurance provider of the patient.
These forms are also available at the client welcome center if you do not have access to a printer.
