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New Patient Forms.

We are providing these forms on the website to allow you to print the forms prior to coming to your first visit.  We encourage you to print the forms and begin filling them out as soon as possible.  It is much easier to complete forms of this type at home as opposed to completing them in the waiting room (though, you are welcome to do it either way).

Please open and print ALL SEVEN of the forms below; fill in information where requested; and bring the forms to your first visit.  Thank you.

Note: Seven forms sounds like a lot, but don't worry, most are very short; several are just informational!

Note: The Patient Questionnaire is a new, simpler version.  The dates and history you provide on the form don't have to be exact (we know how difficult that can be).  For any history more than a couple years old, just use your best estimate.  For recent history or major event/tests, try to be as accurate as possible.  Remember to print ALL SEVEN forms!

1. Patient Questionnaire

2. Communication Release

3. HIPAA/Benefits Policy

4. Records Request

5. Things to Remember

6. Cancellation Policy

7. Preventive-Wellness Visit Notice


PLEASE READ THIS:  If your insurance provides a no-cost annual wellness/preventive visit and you want to use that benefit as your first visit to Dr. Leggett, please make sure our office knows that BEFORE you come in.  If you have already scheduled your first visit, please call our office as soon as possible and tell us that you wish to change your first visit to a "new patient well visit."  We are not able to verify who is or isn't eligible for a well visit from their insurance company, so please check with your insurance company before scheduling a well visit.  Thank you.

The above files require Adobe Reader or some other program that will open a PDF file.  If you do not have such a program, you can download and install Adobe Reader for free by clicking on the link below:

http://get.adobe.com/reader


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