Patient Medical History Form

This form helps us have a better understanding of your condition. If filled out ahead of time, it can be reviewed prior to your first appointment.

 Patient Information Form

This form can be filled out ahead of time, or please arrive 15 minutes prior to your first appointment to complete. Also, please let us know if, at any time, your address or phone number changes and we will update your profile in our records.

 Patient Consent To Treat

Please sign and complete this form prior to being seen by Dr. Reecer or Julie Risley. Also, please note anyone you authorize to have access to your health or financial information. 

 Release of Information

This form lets us know that you would like your medical files sent to another medical professional and lets us know where to send that information (on your behalf).

 Health Insurance Portability and Accountability (HIPAA)

This form lets you know your privacy (medical records, health information) are protected under the law.