Patient Forms & Checklists
New Patients
New Patient Health Questionnaire & Forms (For first time, new patients)
There are seven (7) parts of the form that need to be read thoroughly and completed:
- Click on the links above, open the forms and type right into it - please be be sure to move the cursor manually (do not use 'enter' button) to move from one field to another. When finished, please review entire form making sure that all physician's names, numbers and contact information is included. Also, please be sure to include pharmacy name and list your current medications and their dosages, if applicable. After reviewing, please click the "print form" button on the bottom of the form. You can save a copy of the completed form to your computer for your records and bring the printed copy to your first appointment. If it is easier, print the entire form and complete manually. Thank you
Having Surgery
- Pre-Op Checklist (PDF)
- Informed Consent/Risks & complications associated with surgery (PDF)
- Surgery Guide/Manual (PDF)
- RFA Checklist