For your convenience, we offer our registration forms on our website for you to directly download and complete prior to your appointment. Each form is a PDF document that can be viewed with Adobe Acrobat Reader.
Each form is a PDF document that can be viewed with Adobe Acrobat Reader
For your convenience, all of the CPC forms have the following capabilities:
Option 1: You can immediately print the forms from your computer, then hand-write all your information directly on the forms and bring the completed forms to our office at the time of your appointment.
Option 2: Save the form to your computer:
- Internet Explorer: click the “Save” icon in the upper left corner of your browser
- Google Chrome: move your mouse to bottom of the screen and click the “Save” icon
- Mozilla FireFox: click the “Save” icon in the upper right corner of your browser window.
Locate the saved PDF form file on your computer and fill out the form directly on your screen by typing into the colored boxes. As you’re filling the colored fields with your information, be sure to save your information every 5-10 minutes to ensure it will not be lost due to a computer problem. You can do this by clicking “File” > “Save” in Acrobat Reader. Once your form is completed, you can keep it on your computer for future use or print the form and bring it to our office at the time of your appointment.
Forms to download and fill out if you need to do any of the following:
- New Patient Information: Demographics, Insurance information, Authorization to Release Medical Records, and Office Policies
- Insurance Update Form: To update change in insurance policy
- Authorization To Release Medical Information Form: To allow someone to access your medical information in case of an emergency or otherwise (parent, spouse, family member, friend): *- please note without this form you can not obtain lab results, make appointments for, or discuss medical information with us about your parent, spouse, family member, or friend.
- Advance Directive Form: An advance directive tells your doctor and your family what kind of care you would like to have if you become unable to make medical decisions for yourself.
- Authorization Release of Private Health Information
- Consent to Obtain External Prescription History
- Controlled Substance Prescription Agreement
- Medical Record Release
- New Patient Registration
- Notice of Privacy Practices
- Patient Information Update