![[ICO]](/icons/blank.gif){kind=icon}
![[PARENTDIR]](/icons/back.gif){kind=icon}
![[ ]](/icons/layout.gif){kind=icon}
| Name | Last modified | Size | Description |
|---|---|---|---|---|
| Parent Directory | - | ||
| ELECTRONIC_DISCLOSURE_NOTICE.pdf | 2013-07-03 13:37 | 9.2K | |
| FieldsPatientFormNew.pdf | 2015-05-04 14:47 | 95K | |
| FieldsPatientFormRev518.pdf | 2018-06-05 12:51 | 121K | |
| FieldsPatientRegistration-2.pdf | 2011-10-05 09:28 | 130K | |
| FieldsPatientRegistration-3.pdf | 2011-10-12 10:25 | 166K | |
| Notice_of_Privacy_Practice.pdf | 2013-09-23 11:05 | 21K | |
| Notice of Privacy Practices.pdf | 2017-04-27 09:55 | 410K | |
| referral form.pdf | 2016-12-16 12:55 | 75K | |