Forms 2017-01-31T17:08:19+00:00

Important Forms

Our office will handle your medical records with complete confidentiality. However, if another healthcare provider who is also involved with your care refers you to us, it is customary to send that provider a report of our findings and recommendations. We will provide him or her with such a report unless you instruct us otherwise. We do not release medical records to others without receiving prior written authorization from the patient.

Please use BLACK ink when filling out the forms. Thank you!

New Patient Paperwork
English Download
Spanish Download

Medical Records Release Form

If you have any questions or comments please feel free to email us at or give us a call at (540) 438-1314