Forms
In an effort to help our patients spend less time in our waiting room filling out forms we have included all the necessary forms right here on our website. [Please note that these forms are in PDF format and may take a few moments to download. If you don't have Acrobat Reader, download your free copy here.]
Registration Forms
Please read "Before Your Visit: General Information For Our Patients" before your first visit to our office. We encourage you to print out the each of the forms below, fill them out in the comfort of your own home or office and then simply bring them with you to your visit.
Patient Demographic
- Medical History (7 pages)
- Medical Records Release Authorization
- Know your Insurance
- Peace of Mind is Our Priority
- Acknowledgement of Receipt of Notice of Privacy Practices (HIPAA)
- Authorization of Use and Disclosure of Protected Health Information
Privacy and The Health Insurance Portability and Accountability Act (HIPAA)
Tower Surgical makes every effort to maintain HIPAA compliance in all aspects of our practice. A copy of our policy is available by clicking below. Please take a few moments to review this notice and if you have any questions, please contact our Practice Administrator. You will be asked to sign an acknowledgement that our notice has been made available to you. You are also able to authorize disclosure of your health information to your family or loved ones. Links to each of those forms are available below.
- Notice of Privacy Practices
