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forms

Forms for you to print, fill out, and bring to your first appointment:

New patient: Registration form

New patient: Your medical history (adult over 18, or close to 18)

New patient: medical history (baby/child under 18)

Other forms you might want:

release of records – fill out and send to previous care provider/s, to get your old records sent to Dr. Leigh

subscription contract

Medicare private contract

Policies and advice:

payment plans

basic fees

clinic policies

YOUR RIGHT TO PRIVACY

medical identity theft

DEALING WITH INSURANCE

advance directives: please read!

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