≡ Menu

FORMS & POLICIES

Please follow the links below to download and fill out the forms you’ll need for your appointment.

The forms are required prior to your first appointment. If you have any questions about the forms we’ll be happy to answer them when you come in for your appointment.

New Patient Form Dr. Matta

New Patient Form Dr. Syoufi

Records Release Form

Blood Sugar Log

 

 

Here’s what you need to do to get started before your appointment.
  1. Make sure you have spoken with one of our staff before your appointment.
  2. Complete the new patient information form that applies to you.
  3. Review and sign the patient privacy (HIPPA) form that reviews your privacy protection under the law. This is how you know everything stays confidential.
  4. Bring any medical records you have with you, particularly laboratory tests, blood sugar logs and meters, pump downloads, thyroid ultrasounds. Although we often request prior medical records from other providers, they do not always arrive on time.The best way to assure that we receive your records is to bring them with you.
  5. Bring driver’s license and health insurance card.