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New Patient Registration
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Please bring current insurance cards
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Please bring photo identification such as a drivers license
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If possible, please print and fill out the HIPAA Agreement
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This agreement ensures that the Brookside will maintain the confidentiality and secrecy of protected health and all other patient information.
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If possible, please print and fill out the Comm Form
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This agreement gives Brookside permission to share your information with individuals of your choosing. It also lets Brookside know how you prefer to be contacted.
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If possible, please print and fill out the Records Request Form
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This form allows Brookside to request records from your previous PCP.
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If possible, please print and fill out the Comm Registration Form
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If Brookside refers you to a specialist, this form will allow us to exchange office notes with that specialist.
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