Forms

You can use the following instructions to check in online:

Online Check-In Instructions opens in a new tab

To save time, please print out the following forms and bring them to your first appointment:

New Patient Registration Form opens in a new tab

Intake and History Form opens in a new tab
This form authorizes Clear Choice to request medical records from your previous providers.

If you have important medical history or a history of skin cancer, please provide your attending provider's information.

Medical Records Request opens in a new tab

This notice is for your information and is optional to print:

HIPAA Privacy Notice opens in a new tab

Para ahorrar tiempo, imprime y llene la forma y tráigala a su primera cita:

Forma para nuevos pacientes opens in a new tab

Historia y Formulario de Admisión opens in a new tab

Este aviso es para su información y es opcional para imprimir:

Aviso de HIPAA de prácticas de privacidad opens in a new tab