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Hospital Affiliation

Privacy Notice

Forms for New Patients

If your are a new patient, please fill out the registration forms below and bring them with you when you come for your appointment.

Registration Forms

Patient Registration Form

Patient Consent Form

Financial Policy

Authorization for Release of Protected Health Information (PHI)

Privacy Notices

This privacy notice describes how health information about your child may be used and disclosed and how you can get access to this information. Please review it carefully.

Notice of Privacy Practices

Aviso Sobre Las Practicas De Privacidad

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