Instructions for Your First Visit and for Completing New Patient Forms

Prior to your appointment, you can view and download our new patient paperwork. Please complete forms 1 and 2 below and bring them with you to your first visit. The forms need to be completed by the patient or legal guardian. Note: These forms are provided in PDF format and requires Adobe Reader to open and view (click here to download Adobe Reader).


1. PATIENT INFORMATION AND MEDICAL SCREENING FORM
This form is used to provide our office with the patient's personal (name, date of birth, address, etc.) and insurance information, to provide our cardiologists with your medical history, to give your consent for receiving care, and for our office to release medical information to your primary care doctor or others, when needed.

2. MEDICAL RECORDS RELEASE AUTHORIZATION
This form allows our office to request and/or send your medical records from our office or from your other doctors or other medical facilities, when needed.

Please arrive 30 minutes before your appointment, and bring:

  • Your completed patient information forms.
  • Your insurance card(s).
  • Sufficient funds to pay your visit co-payment (cash, check, VISA, MasterCard, Discover).
  • All your prescription medication bottles (We need the bottles!).
  • Any non-prescription medications, vitamins, and supplements that you take.

Here is a website link that may be helpful to you before your appointment:

Be Prepared for Medical Appointments - http://www.ahrq.gov/questionsaretheanswer/

The following notice describes how medical information about you may be used and disclosed and how you can get access to that information.

Our Privacy Practices for Protected Health Information