For your convenience, please complete the following forms prior to your first visit.
Per insurance regulations, this form must be updated yearly, even if there are no changes.
Complete this form to the best of your ability. If you have any questions, the nurse and Dr. Brooks will review this form with you during your visit.
This form gives us detailed information on how you wish to be contacted. If you DO NOT check the box, we CANNOT contact you in referenced manner. If you check boxes for persons, other than yourself, to receive information, please supply their names.
This form requires that you acknowledge HIPPA required patient privacy laws. Please read the HIPPA REGULATIONS at
Please complete this form so that we may receive your past medical records.