Patient Forms
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* Authorization for Treatment
(416K)This form gives us permission to medically treat your child. All new patients must have this form completed. -

* NPP Acknowledgement Form
(61K)All new patients must have this form on file. This form states that you have received a copy of the Notice of Privacy Practice (NPP). The NPP can be downloaded using the link below, or read online in the policies section. -

* New Patient History
(98K)A medical history form for all new patients. -

* New Patient Profile
(206K)This form contains demographic information. All new patients need to have this form completed. -

Authorization for Release of Medical Information
(64K)Use this form to request a transfer of medical records to OPAM or from OPAM to another facility. -

Guardian Consent Form
(56K)This form allows someone other than the child's legal guardian to seek healthcare on the child's behalf. -

Notice of Privacy Practice
(105K)This is a downloadable version of the NPP. This document explains how your personal health information is protected and used.
