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Patient Forms

All forms are available on the Patient Portal. However, if you have issues accessing the portal or want to preview some of the required forms, you may download the forms below.

Patient Rights & Responsibilities

HIPAA Privacy Authorization

HIPAA Release Form

Patient Consent Form

Medication History Consent Form

Credit Card on File Policy

Referral Form

Contact Us

8215 Madison Blvd. Suite 150

Office: (256)325-2500

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