Please print and fill out only the forms that you are instructed to complete and bring with you to your appointment.
HIPAA GHS Forms: Acknowledgement Form Medical Record Release Form Patient Appointment Representative Form Privacy Notice Form	HIPAA SASC Forms: Acknowledgement Form Medical Record Release Form Patient Appointment Representative Form Privacy Notice Form Brief Privacy Notice Form
GHS General Forms: Medical History Form Medication List Form Patient Registration Form Professional Service Agreement Form	SASC General Forms: Medication List Form Patient Rights & Responsibilities Form Professional Service Agreement Form Satisfaction Survey Form
Form Charges: 2009 Charges For Disability Forms	Download Adobe Reader to view forms: