For New Patients

 

If you are a new patient to our office, the following list of forms will need to be filled out when you arrive for your appointment before you can be seen by Dr. Sober.  It will greatly assist us, and it will help you to be seen in a much more timely manner, if you will download the forms and print them first, and then fill them out by hand completely prior to arriving for your appointment.  Please do not attempt to fill them out on your computer as they are not designed for that method.  Thank you so much for your help with this.

 

Also, if there is more than one person in a family that will be seen as a new patient, one set of forms will be needed for each person.

 

Download
Patient Medical History Form
Patient Medical History Form.pdf
Adobe Acrobat document [38.3 KB]
Download
Patient Registration Form
Patient Registration Form.pdf
Adobe Acrobat document [34.3 KB]
Download
Authorization for Disclosure of Protected Health Information
AuthorizationtoReleaseProtectedHealthInf[...]
Adobe Acrobat document [59.1 KB]
Download
HIPPA Notice of Privacy Practices
Read only form
HIPPA Privacy Practices.pdf
Adobe Acrobat document [752.3 KB]
Download
Acknowledgement of Receipt of HIPPA Form
Acknowledgement of Receipt of Notice of [...]
Adobe Acrobat document [30.6 KB]

The above documents utilize Adobe Acrobat Portable Document Format (pdf), and require the use of Adobe® Acrobat® Reader.  You can download the program for free from their site by clicking on the link to the right.