New Patient Forms

For adult patients:

Please print out this PDF and fill it out entirely.

For pediatric patients (8 yrs and below):

Please print out this PDF and fill it out entirely.


All patients:

Please review this PDF to familiarize yourself with clinic policy and HIPAA regulations.

Please review this PDF for CCRC Consent to Communicate PHI by Email

Please note, there is free parking in our lot, located immediately south of our building and accessed from E. 6th Street.