Accepted Insurance Plans

Billing Information

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If you would like to take the time to complete the applicable forms prior to your initial visit, the forms are available in printer friendly versions below, for your convenience.

English

• Authorization for Release of Confidential Medical Records (English)
  download form
• Authorization for Release of Confidential Medical Records - Minors (English)
  download form
• Medical History (English)
  download form
• Medical History OB/GYN (English)
  download form
• Medical Record Release Form
  download form
• New Patient Questionnaire - Pediatrics (English)
  download form
• Registration Form (English)
  download form
• HIPAA Notice of Privacy Practices (English)
  download form
• Financial Policy (English) 
  download form

Espanol

• Authorization for Release of Confidential Medical Records (Spanish)
  download form
• Authorization for Release of Confidential Medical Records - Minors (Spanish)
  download form
• Medical History OB/GYN (Spanish)
  download form
• Medical History (Spanish)
  download form
• New Patient Questionnaire - Pediatrics (Spanish)
  download form
• HIPAA Notice of Privacy Practices (Spanish)
  download form
• Financial Policy (Spanish) 
  download form
• Registration Form  (Spanish)
  download form

Polski

• Authorization for Release of Confidential Medical Records (Polish)
  download form
• Authorization for Release of Confidential Medical Records-Minors (Polish)
  download form
• Registration Form (Polish)
  download form
• Financial Policy (Polish)
  download form
• Medical History (Polish)
  download form