Registration Forms

Please print the following forms completing them in advance of your appointment. BE SURE TO READ ALL FORMS AND INSTRUCTIONS CAREFULLY. Bring the completed forms with you at the time of your first appointment. Please arrive at the office 15 minutes in advance of your appointment time, making yourself comfortable in the reception room. If the office manager is not present, Dr. Zeitner will receive your registration materials and will copy your insurance card at the time that he greets you.

Registration Form
REGISTRATION FORM.doc
Microsoft Word Document 32.5 KB
Consent for Treatment
CONSENT FOR TREATMENT.docx
Microsoft Word Document 11.5 KB
Confidentiality Agreement
CONFIDENTIALITY AGREEMENT.docx
Microsoft Word Document 12.8 KB
Notice of Privacy Practices
NOTICE OF PRIVACY PRACTICES.docx
Microsoft Word Document 19.1 KB