To make check-in as efficient as possible, you may print the following forms and complete them prior to your visit. Please bring each form with you on the day of your appointment.
Your contact, pharmacy and insurance information.
Your information. Your rights. Our responsibilities.
Authorize the release of your medical records.
Your medical history and current healthcare needs.
Consent to treatment and financial responsibility, and with whom you would like that information shared.
How information about you may be used and how to access this information.
Tell us if you would like to be considered for clinical trails in conjunction with NCR.