Please select the form you need, print it and fill it out. Please bring the signed and completed forms to your office appointments, as required.

Patient History	Word
Patient Information	Word
Notice of Privacy Practices - Consent Form	Word
Patient Financial Policy Sheet	Word
Personal Release	Word

Camp Forms/School Forms
Forms will be mailed to parents within one week of receipt. Forms will not be completed during your visit. Forms will not be faxed directly to camp or school. Parents are responsible for getting these documents to camp or school.

Accepted Insurance:
United Healthcare (all)
Blue Cross Blue Shield (all)
Definity Health
Health Smart
Humana
Beech Street
Employers Health Direct
Fortis Insurance Company
GEHA 4 Health
Great West
Group and Pension Administrators
One Health
Pacific Care (all)
Aetna (all)
Cigna (all)
John Alden Life Insurance Company
NTHN
Harrington Benefit
Tricare
Traditional Medicaid
Amerigroup
Cook's Children