Instructions for Your First Visit and for Completing New Patient Forms
Prior to your appointment, you can view and download our new patient paperwork. Please complete forms 1 and 2 below and bring them with you to your first visit. The forms need to be completed by the patient or legal guardian. Note: These forms are provided in PDF format and requires Adobe Reader to open and view (click here to download Adobe Reader).
1. NEW PATIENT INFORMATION AND MEDICAL SCREENING FORM
This form is used to provide our office with the patient's personal (name, date of birth, address, etc.) and insurance information, to provide our cardiologists with your medical history, to give your consent for receiving care, and for our office to release medical information to your primary care doctor or others, when needed.
2. AUTHORIZATION FOR RELEASE OF PROTECTED HEALTH INFORMATION
This form allows our office to request and/or send your medical records from our office or from your other doctors or other medical facilities, when needed.
Please arrive 30 minutes before your appointment, and bring:
- Your completed patient information forms.
- Your insurance card(s).
- Sufficient funds to pay your visit co-payment (cash, check, VISA, MasterCard, Discover).
- All your prescription medication bottles (We need the bottles!).
- Any non-prescription medications, vitamins, and supplements that you take.
Be Prepared for Medical Appointments - http://www.ahrq.gov/qual/beprepared.pdf
The following notice describes how medical information about you may be used and disclosed and how you can get access to that information.
