Forms
Please click on the forms below, print them, and have them filled out for your
appointment with Dr. Martez.
- Patient
Registration Form - This form is filled out by all new
patients in order to register with our practice. Please print this form and fill
it out before your first visit. Thank you!
- Financial
Policy Form - This form describes our financial policies and rules. This form is filled out by all new patients in order to register with our practice. Please print this form and fill it out
before your first visit. Thank you!
- Consent for Treatment - This is a consent form that
will give the Dr. Martez the right to offer treatment.
- Notice
of Privacy Practices Form - This form is for
notification of privacy policies. This file does not need to be printed and brought in with your other paperwork.
- Health
History Form - This form will declare your current health
history. Your doctor will review this heath history during your first visit.
**All information given is held in strict confidentiality.