New Patient Form for Private Practice

Are you new in Private Practice?

Do you ever feel overwhelmed with creating forms and policies…maybe you don’t know where to start? 
Do you need a Consent Form /HIPAA Form /Privacy Form / Financial Form???

In my practice I try to keep things as simple as possible and consolidate paperwork as much as possible.

Would you like to feel confident that you have a simple form that covers all the bases? 

This New Patient Form serves the following functions:

• Collect Demographic Information
• Collect Insurance Information
• Collect Patient’s Doctor Contact Information
• Communicate Late Fees / Cancellation Policy
• Communicate Financial Policy & Billing Information
• Communicate Privacy / HIPAA / Communication Policy
• As a consent for Treatment 

It can be fully adapted to your office and your policies. (If you are unsure of what to include in your new patient form you are advised to review it with a lawyer prior to use.)

The form can  be used as a printed form, as an email attachment, as a link on your website or uploaded in to your EMR.