David’s Forms

Adult Registration Forms:

Please print and fill out each form and bring Numbers  1-4  with you to your appointment

1. Adult Registration Form

2. Adult History Form

3. Disclosure Statement

4. Notice of Privacy Practices

5. Fee Agreement

6. Directions to the Office 

7. Telemedicine Policy

8. Visa Agreement–if You are Using 

9. Good Faith Estimates Will be Furnished upon Request