Below you can select and print the necessary forms for your upcoming visit. Complete the forms and give them to the Patient Representative when you check in for your appointment.
You can present the completed forms to the check in desk upon your arrival ... page form if you are having your annual gynecological exam (pap smear).
Demografía de los pacientes constituyen el núcleo de los datos para cualquier institución médica. Ellos permiten la identificación de un paciente
Required HIV Related Consent and Authorization Forms. HIV-Specific Model Consent.
Before your first appointment, fill out a new patient form for... time at your first appointment by printing and filling out these forms before your visit.
This notice explains how medical information about you may be used and how you can get access to this information.
AUTORIZACIÓN PARA LA DIVULGACIÓN DE INFORMACIÓN DE SALUD DE CONFORMIDAD CON ... [Este formulario ha sido aprobado por el Departamento de Estado de Nueva York de la Salud].
AUTHORIZATION FOR RELEASE OF HEALTH INFORMATION PURSUANT TO ... [This form has been approved by the New York State Department of Health].
NEW YORK STATE DEPARTMENT OF HEALTH AIDS Institute HIV-Specific Model Consent Form Informed Consent to Perform HIV Testing
Patient demographics form the core of the data for any medical institution. They allow for the identification of a patient.