Forms

To save time spent on paperwork, please print and complete the forms below and bring them to our office, or fax them to us at (801) 224 2966.

Patient Registration Form Once your appointment is confirmed, please print and complete this form, and bring it with you to our office, or fax it to us at (801) 224 2966.	Click here to download
Medical Health Questionnaire If you want to provide your medical health information to us (optional), please print and complete this form (to the extent you can), and bring it with you to our office, or fax it to us at (801) 224 2966.	Click here to download
HIPAA Consent Form By signing on this form, you agree to the use and disclosure of your health information for treatment purposes, payment activities and healthcare operations of our office.	Click here to download
Medical Record Release Form If you want to authorize the release of your medical records from your existing health care provider to us or someone other than yourself, please print and complete this form, and bring it with you to our office, or fax it to us at (801) 224 2966.	Click here to download
Financial Policy	Click here to download