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Registration & Forms


  • Patient Information
  • Patient Medical History
  • Advanced Directive Notification
  • Authorization To Designate Release Of Health Information
  • Authorization For Release Of Records
  • Authorization to Disclose Health Information
  • HIPAA Privacy Policy Statement
  • CA Advanced Health Care Directives
  • Office Policies Signature Sheet
  • Request or Refusal for Language Interpretive Services
  • Office Policies for Our Valued Patients
  • Acknowledgement of Receipt

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We are located in
Palm Springs, CA 92262

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