Patient forms
If you are a new patient, or if any information about your contact information, health status, insurance or HIPAA has changed, please complete all four (4) forms listed below:
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Medical Information for Upcoming Visit |
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Patient Information Form |
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Patient Information, Medical Record Release, and HIPAA Authorization | |
Financial Policies Form |
If you can't open the forms, you'll need to install the Adobe Reader. Click the button below to install:
Please feel free to clarify directions by clicking on the Contact Us tab or by reviewing directions with a staff member in our office prior to your appointment.
Dr. Mitchell has a mutual respect for appoinment times and would like both your and her schedule to stay as close to on time as reasonably possible; therefore,
If you are bringing the forms with you:
Arrive 10 minutes prior to your appointment time to allow for entry of your information and collection of appropriate fees so that the doctor may see you in a timely manner.
If you are filling out the forms in the office:
Arrive 20 minutes prior to your appointment time to allow yourself time to fill out your paperwork and office staff to enter your information, and collect appropriate fees so that the doctor may see you in a timely manner.
Persons arriving late (not in accordance with these requirements) may be asked to reschedule their appointment at the discretion of the office manager or Dr. Mitchell.
Thanks for your understanding and attention to this policy.