Patient Forms

If this is your first appointment with The Clinic For Neurology please take a moment to fill out the necessary forms ahead of time in order to streamline the process on the day of your appointment. This saves you waiting time and gives you time to properly look over the forms and determine if you have any questions for the clinic.

Demographics - New Patient Form


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HIPAA Notice of Privacy Practices


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Electronic Consent Form


Click Here to Download

Financial Policy


Click Here to Download

Medical History Form


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Medication List Form


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Patient Portal Information


Click Here to Download