|
| |
Forms to complete before your visit:
In order to
save time and to have you seen by the doctor as quickly as possible:
-
Open and print the
required forms, and any optional ones you think are needed;
-
The forms are a little long and a bit complex, take your
time and write out any questions;
-
Complete and sign the forms
(do not worry if you have to leave a line or two blank);
-
Bring the forms with you
on your first visit;
-
We have tried our best to make the forms short and
easily understood. If you have trouble with them, ask us for our
help. We are glad to explain the forms. Don't sign anything
you don't understand (here or anywhere else); and,
-
If you do not sign some of these forms, we may not be
able to see you.
The
forms require Adobe Acrobat reader (most personal computer have this
installed). If you do not see these forms when you click the link, visit Adobe and
download the
free Acrobat Reader.
REQUIRED FORMS
OPTIONAL FORMS
-
Medical records release
(use this only if you need to get records or x-rays before the first
visit)
-
Acupuncture consent
form (use this only if you want to consider acupuncture treatment)
-
Lien cover letter (use this form only if you do not have insurance
and want to be seen on a personal injury lien)
-
Lien contract (use this form only if you do not have insurance and
want to be seen on a personal injury lien)
-
Pain
contract and pain
medication information (use this form only if you use long term
narcotic treatment and want our practice to prescribe your medications)
-
Durable Power of Attorney (use this form if you are seriously ill so
that your family can help with medical decisions if you are too sick
to speak for yourself, this form is from Missouri but is legal here and
is, in my opinion, clearer than the California version)
| |
|
