Wednesday, February 22, 2012

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Instructions

Please complete and bring the Patient Registration, Patient History, HIPAA Consent, Authorization to Disclose and Financial Policy forms to your first appointment.

  1. Click on the link for each form
  2. Save the form to your desktop
  3. Type in any information requested
  4. Print your form
  5. Sign your form if necessary

The Mind Matters Privacy Practices is for you to read and keep for reference.

Forms Library

Mind Matters, PC | 15050 SW Koll Parkway, Suite 2A, Beaverton, OR 97006 | ph: 503.352.0468 | fx: 503.352.1024 | info@mindmatterspc.com

Copyright 2010 by Mind Matters, PC