New Patient Forms
At Evergreen we know you are busy so we want to make your first visit as effecient as possible. Below you will find links to the 5 documents that we would have you read, fill out, and sign in our lobby before your first appointment. Please feel free to print them out – read them – fill them out – and sign them before you arrive. Now you can come and relax for a few minutes in our comfortable lobbies before you see your practitioner.
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Acknowledgement Of Private Practices Document Signature Required after reading “Notice of Privacy Practices” |
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Consent For Use & Disclosure of Protected Health Information Signature Required |
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Notice of Privacy Practices Read Only |
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Evergreen Registration Form Fill Out, Signature Required |
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Medicare Supplier Standards Read Only |
