Patient Forms 2018-05-01T09:15:37+00:00

Patient Forms

Medical forms to get US started

I can’t wait to meet you on our first visit!

Since I want to provide the best care possible, please print out these 2 documents:

1. Patient Information
2. Patient Questionnaire

Take the time to carefully complete these forms so that I can develop a health plan with you.
You will also need to read the Patient Agreement form and the Privacy Practices notice. (HIPAA). There is no need to print these out as I like to review these documents in person and answer your questions. I have them laminated in my office so that we can sign them together. Note: I can scan them into your chart and then wipe them off – saving lots of trees.

Patient Information
Patient Questionaire
Patient Agreement
Privacy Practices (HIPAA)
Medical Records Release

I look forward to serving you at your first visit.

Thank you for choosing me, Dr. Wendy Schilling, to help care for your needs.