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Office Information: Medical Forms

Provided below are various forms that require completion prior to your visit and/or surgery. Please download the appropriate form as directed by your physician and/or staff by clicking on the name of the form. If you cannot access the form, please click on the Adobe icon. This will allow you to download this software, providing access to the forms. Please bring the completed form(s) with you to your scheduled visit. This will help expedite the registration process. Thank you.

If you cannot access the forms you can click on the icon to download the software.
Dr. Granger, Dr. Hall, Dr. Guin, Dr. Moore and Dr. Bullington Medical Questionnaire Patient Information Medication Policy HIPAA Acknowledgement Medicare Questionnaire (only for those who have Medicare) Dr. Choquette Patient Medical History Patient Information Medication Policy HIPAA Acknowledgement Medicare Questionnaire (only for those who have Medicare) Dr. Chitwood New Patient Form Patient Information Medication Policy HIPAA Acknowledgement Medicare Questionnaire (only for those who have Medicare) Dr. Alford and Dr. Werner New Patient Form Patient Information Medication Policy HIPAA Acknowledgement Medicare Questionnaire (only for those who have Medicare)	Dr. Brooks, Dr. Lett and Dr. Potter Patient History and Information Patient Information Medication Policy HIPAA Acknowledgement Medicare Questionnaire (only for those who have Medicare) Dr. Tim Haley Patient Questionnaire (only for treatment of neck, back, and hip) Health History (only for treatment other than neck, back and hip) Patient Information Medication Policy HIPAA Acknowledgement Medicare Questionnaire (only for those who have Medicare) Dr. Hanson, Dr. John Haley, Dr. Maddox, Dr. Simpson, Dr. Robinson, Dr. Lolley, and Dr. Dungan Health History Patient Information Medication Policy HIPAA Acknowledgement Medicare Questionnaire (only for those who have Medicare)
Optional Forms Patient Survey Medical Records Release Form Notice of Privacy Practices Financial Policy