Save time when you register as a new
patient. You can fill them out in the comfort of your home and bring
them with you to your appointment.
Follow the simple steps below.
You will need Adobe Acrobat Reader installed
on your computer. If you do not have Adobe Acrobat Reader, it's
available FREE from Adobe.
Print the form and fill it
out by hand.
Bring your completed forms with you to
your appointment and give them to the receptionist when you register.
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If unusual circumstances
prevent you being present when we see your child, then we will need a
signed copy of either:
"Consent by Proxy for Non-Urgent
Minors Care"
(authorizing
someone else, who accompanies your child, to make health related
decisions for you regarding your child's care) or
"Pre-Authorization to Treat Minors Consent"
(if you need to give us a one-time OK to see your unaccompanied child.)
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