Office Forms & Notices

Here you can find various documents, forms, and notices which may be read or downloaded.

To view these PDF files, download the most recent version of Adobe Acrobat Reader if you don't already have it. You may click on the Adobe Reader icon below to get it. Once installed, click on the name of the document you wish to view or print.

• Patient Intake Questionnaire (pdf)

The above "Patient Intake Questionnaire" should be downloaded to your computer (3.8mb) and then filled out in it's entirety.

When you open the file you should see a pink or purple section across the top of the page. If they are not highlighted already, you may click the button in that pink/purple area to highlight all the fields that should be filled in. Once you have finished filling out your Questionnaire, you should save it to your computer and then click the "Click to Send by Email" button at the bottom of the last page.

This will open a new email in your email program addressed to us with the questionnaire file all ready to go. You may either just add a subject and hit send or add a note for us if you wish.

The file is rather large, so don't fret if it takes some time for the email to be sent.

Please read the Patient Intake Qestionnaire information at left. This file is very similar.

• Epworth Sleepiness Scale (pdf)

• Financial Policy (pdf)

• Consent for Purposes of    Treatment, Payment and    Healthcare (pdf)

• Authorization for Use and    Disclosure of Health Info. (pdf)

• Notice of Privacy Practices (pdf)

• Notice of Privacy Practices    Acknowledgment (pdf)