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Patient Registration Forms

USA conveniently provides our patient registration forms online so you can easily download and print. You can help expedite your appointment by completing and bringing your paperwork with you to your appointment. All you need is Adobe Reader or Acrobat and a printer. Follow the directions below.

1. Do you prefer to write with a pen or type?  

Write 

 After you download the form, simply print it (File > Print or Right Click>Print) then using black or blue ink, write in your answers. Bring the completed form to your appointment.    

Type

After you download the form, type your information in the blue boxes and then print (File > Print or Right Click > Print). 

Bring the completed form to your appointment.


2. Get the form 

Click on the name of the registration form you need. It will open in Adobe Reader. Complete the form, print it out, and make sure to bring the completed form to your appointment.
 
     Adult Patient Registration Form  or Registro de pacientes adultos

     Child Patient Registration Form

     Prosthetic Patient Registration Form

Please note, Adobe Reader or Acrobat is needed to view and complete the form. If you need to download Adobe Reader click here.

Bring the completed forms with you to your appointment

If you have questions please call us at (423) 267-0466.