Patient Forms

We ask that all new patients complete our New Patient Health History form online prior to their first appointment. Completing your forms now will save you time in the office.

Additionally, we request all patients complete and submit the AAOIC Supplemental Informed Consent Form prior to the first appointment following our re-opening date following COVID closures. This form only needs to be completed once.

First Visit Patient Forms

Child Health History Form

Child Health History Form – Spanish

Adult Health History Form

Adult Health History Form – Spanish

HIPAA

HIPAA – Spanish

HIPAA Acknowledgement

HIPAA Acknowledgement – Spanish

Informed Consent Form (Only Complete Once)

Informed Consent – Spanish (Solo es necesario completar este formulario una vez)

AAOIC Supplemental Informed Consent (Only Complete Once)

AAOIC Supplemental Informed Consent – Spanish (Solo es necesario completar este formulario una vez)

Pediatric Sleep Questionnaire

Pediatric Sleep Questionnaire – Spanish

  • Please contact our office if you have any questions regarding these forms.