Forms & Policies

Are you making a visit to our clinic?

Here are some forms you may need:

NOTICE OF PRIVACY PRACTICES

PATIENT DEMOGRAPHICS FORM

MEDICAL RECORDS REQUEST

NOTICE OF NON-DISCRIMINATION

YOUR RIGHTS AND PROTECTIONS AGAINST SURPRISE MEDICAL BILLS

Referral Form

Financial Policy

GOOD FAITH ESTIMATE

BREATHING TEST INSTRUCTIONS

CT SCAN INSTRUCTIONS

6-MINUTE WALK TEST INSTRUCTIONS

Masking Policy

We will continue to follow Bryan’s Masking policy throughout cold & flu season, requiring masks for staff and patients in all areas.