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Patient Forms

Please arrive at least 25 minutes early to your first appointment in order to complete our electronic paperwork. Bring any additional completed forms to your first appointment, along with your medical records, referral (if your insurance requires one), valid medical card, and drivers license or other form of photo identification. The privacy notice is provided here for your reference only.

• Sleep Disorders Questionnaire ( 40Kb PDF )
• Notice of Privacy Practices  (18Kb PDF - reference only)
• Waiver For Mental Health Benefits (7Kb PDF) - for Dr. Schmalz only

You will need Adobe Reader to view PDF files.  If you do not have the reader you can download it free using the link below.

http://www.adobe.com/products/acrobat/readstep2.html