FORMS

New Patient Forms

Please print and complete all New Patient Forms, prior to your visit.
Please bring the completed forms with you to your office visit.

New Patient Forms
(all required forms combined in one document)
AIC_NewPatientForms (291KB PDF)
AIC_NewPatientForm (Spanish) (34KB PDF)

Other Forms

Patient Information Form
AIC_PatientForm (64KB PDF)

Patient Questionnaire
AIC_PatientQuestionnaire (48KB PDF)

Privacy Policy and Acknowledgements Forms
AIC_Privacy_Policies (127KB PDF)
AIC_AcknowledgementForm (90KB PDF)

Release Forms
AIC_Personal_Health_Info (76KB PDF)
AIC_Medical_Info_Release (78KB PDF)

Spanish Forms
New Patient Form (Spanish) (34KB PDF)

Patient Information

  • All office visits, except emergencies, are by appointment.
  • Please make separate appointments for each individual family member.
  • When you call for an appointment, the receptionist will ask the nature of your problem in order to allow an adequate amount of time for your visit.
  • If you cannot keep your appointment, please cancel 24 hours in advance. Failure to cancel an appointment 24 hours in advance of your scheduled time may generate a fee.
  • When calling for an appointment, please be prepared to provide the patient’s name, address, phone number, birth date, type of insurance, reason for appointment, and referring physician, if applicable.
  • Alternately you can download, print and complete our Patient Information Sheet, Patient Questionnaire, and other relevant forms and bring the completed forms with you to your office visit.