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.
Patient Information Form
AIC_PatientForm (64KB PDF)
AIC_PatientQuestionnaire (48KB PDF)
Authorization for Release of Medical Information
AIC_MedicalInformationReleaseForm (239KB PDF)
New Patient Form (Spanish) (34KB PDF)
- 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.