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!
- Consent for Treatment & Policies - 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.
- 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.
- Fee Schedule - This schedule shows fees for services offered by Dr. Martez.