Forms

Forms

Please print and complete the following forms before your first visit.

REGISTRATION FORM

INSURANCE RELEASE & PATIENT RESPONSIBILITY

PROFESSIONAL SERVICE AGREEMENT

PROBLEM LIST SUMMARY SHEET

HIPAA FORM

 

 

 

 

 

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The information provided in the website is intended to give general introduction to the services offered by Barnes & Klatt, P.C. and is not to be used as a substitute for assessment or treatment by a medical professional.

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