Herring

Forms

Access and download essential patient forms for your visit and care.

Patient Information

Complete your basic personal, insurance, and medical history information for your first visit.

Authorization and Assignment of Benefits

Authorize us to bill your insurance directly and receive payment on your behalf for covered services.

HIPPA Notice of Privacy Practices

Learn how we protect, use, and share your health information and understand your privacy rights.

Medical Records Release

Authorize the release of your medical records to other healthcare providers, attorneys, or third parties.

Privacy Practices Acknowledgement

Confirm that you have received and understand our privacy practices and policies.

Vehicle Accident Information

Provide details about your vehicle accident, insurance information, and related circumstances for proper treatment and claims processing.