PATIENT INFORMATION

Items needed at time of appointment:

• Patient Information Form (click here for the Patient Information Form)

• Treatment Consent Form (click here for the Treatment Consent Form)(Spanish Treatment Consent Form)

• Insurance Cards

• Authorizations (if applicable)

• Medication List

• Shot Records (if applicable)

• Referral Information (if applicable)

• Medical Records

• HIPAA Compliant (click here for the Privacy Notice)

• Medical Release Form to obtain records from your previous provider or to send records from SSMC to another provider click here