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:
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.
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.
Washington, DC
- 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