Hospital Affiliation
Patient Registration Forms & Privacy Notices
Registration Forms - New Patients
If you are a new patient, please fill out the forms below, completely and accurately, and bring them with you when you come for your appointment. Make sure you also bring your driver's license or other picture ID, and your health insurance ID card(s).
Controlled Substances Contract
Medical Records Release Authorization (as needed)
Privacy Notices
This privacy notice describes how health information about your child may be used and disclosed and how you can get access to this information. Please review it carefully.
Aviso Sobre Las Practicas De Privacidad
These forms require Adobe Reader. If you do not have Adobe Reader, you may download it free here:
(this link opens a new browser window).