Patient Forms
To ensure a smooth first appointment, we kindly ask all patients to download and complete the necessary PDF forms prior to your visit. These forms are essential for us to gather information about your medical history and needs. Please bring the completed forms with you to your appointment, as this will help us provide you with the best possible care. Thank you for your cooperation!
Downloadable Patient Forms
Patient Information
The Patient Information Form is designed to gather essential details about you. This form helps us provide you with the best possible care tailored to your needs. Please fill it out accurately and completely, ensuring that all relevant information is included. Your privacy is important to us, and all information will be kept confidential.
Consent for Treatment
This Consent for Treatment form is designed to ensure that patients understand the nature of the proposed medical treatment, its potential risks benefits, and their right to ask questions. By signing this form, patients acknowledge that they have been adequately informed and consent to receive the specified treatment.
Notice of Health Information Practices
This notice explains that your healthcare provider is part of a non-profit, non-government health information exchange (HIE) known as Health Current. This service is free of charge and aims to enhance coordination of care by allowing secure sharing of your health information among your doctor, healthcare providers, and health plans.
Medical History
Download our Medical History Form to ensure we have all the necessary information for your care. This form is essential for providing you with the best possible service and understanding your medical background. Simply fill it out and bring it with you to next appointment. Your health is our priority!
Financial Policy
At Phoenix Health Practitioners LLC we believe in delivering exceptional patient care. However, our professional services are rendered to you, not your insurance company; therefore, payment for treatment is your responsibility. We are committed to navigating with you to get your best allowed coverage. Please download the form and fill it out.
Medical HIPAA Release Form
The HIPAA release form is a legal document that allows individuals to grant permission for their protected health information (PHI) to be shared with specified parties. This form ensures compliance with the Health Insurance Portability and Accountability Act (HIPAA), which protects patient privacy. Please download and fill out.
Notice of Privacy Practices
This notice describes how health information about you (as a patient of this practice) may be used and disclosed, and how you can get access to your health information. This is required by the Privacy Regulations created as a result of the Health Insurance Portability and Accountability Act of 1996 (HIPAA).