Medical Authorization Forms
- Authorization for Release of Medical Information
- Authorization to Receive Medical Information
- HIPAA Email Consent Form
New Patient Forms
Please fill out your health history form and bring it with you on the day of your appointment. We will need the completed form and your insurance card before you receive treatment.
- Financial Policy
- Monthly Payment Plan Schedule
- ACH Payment Authorization
- Good Faith Estimate
- Notice of Privacy Practices
To register for your Patient Portal Account – please contact the office for a token number or for a secure email link to be sent to you. Once you have a patient portal account set up with NSS you may register with MyLinks to store all your healthcare data from multiple practices in one application. Please contact the office for more information.
These forms are in Adobe Acrobat format. If you don’t have Adobe Acrobat, click here for a free download.