Forms for New Patients

As a new patient, we want you to feel welcome. In order for us to serve you in the best possible way, we will review your medical history, questions, and concerns together

Please fill out our online patient information form and patient history form to the best of your ability. If you have any questions, please contact us and we will be happy to assist you

Our forms are in compliance with HIPAA laws and regulations. Your personal information will be kept confidentially in our office and will not be released to any person except when you have authorized us to do so, or if it is authorized by law

Please see our Notice of Privacy Practices for more information

To share records or notes with our office, please click here (upload.ruxinmd.com)