Forms

Forms & Patient Information

New Patients

Prior to the first visit, new patients will need to fill out the following forms. You may print the following forms, fill them out, and bring them with you to save time at the office.

• Basic Patient Information / Registration

• HIPAA form

• Dr. Fuisz (new patients only)

• Dr. Enelow (new patients only)

Current Patients

• Prior to each visit, all current patients should ensure their information is up to date via the Patient Portal.

• Scheduled for either Virtual Physical or in-person Physical? Dr. Fuisz and Dr. Mills patients electronic form

• Prefer writing things out? Dr. Fuisz current patients printable pdf

Other Forms

• Medical Records Request (from another doctor’s office)

• Medical Records Release (to another doctor’s office)