Forms
Please complete forms 1 – 5: Patient History Sheet, Patient Demographic, Continuum of Financial Responsibility, Notice of Privacy Practice Acknowledgement, and Patient Acknowledgement of Financial Policy.
![](https://www.elizabethsaladamd.com/wp-content/uploads/2016/08/thumb-patient-history-sheet.jpg)
![](https://www.elizabethsaladamd.com/wp-content/uploads/2016/08/thumb-patient-demographic.jpg)
![](https://www.elizabethsaladamd.com/wp-content/uploads/2016/08/thumb-continuum-of-financial-responsibility.jpg)
![](https://www.elizabethsaladamd.com/wp-content/uploads/2016/08/thumb-notice-of-privacy-practice.jpg)
![](https://www.elizabethsaladamd.com/wp-content/uploads/2016/08/thumb-patient-acknowledgement-of-financial-responsibility-1.jpg)
![](https://www.elizabethsaladamd.com/wp-content/uploads/2016/08/thumb-authorization-to-release-medical-info-1.jpg)
![](https://www.elizabethsaladamd.com/wp-content/uploads/2016/08/thumb-notice-of-privacy-practices.jpg)
![Agenda Setting Form thumbnail](https://www.elizabethsaladamd.com/wp-content/uploads/2019/05/agenda-form-thumbnail.png)
![Patient Information thumbnail](https://www.elizabethsaladamd.com/wp-content/uploads/2019/05/patient-information-thumbnail.png)
![Tuberculosis Questionnaire thumbnail](https://www.elizabethsaladamd.com/wp-content/uploads/2019/05/tuberculosis-questionnaire-thumbnail.png)
Please complete forms 1 – 5: Patient History Sheet, Patient Demographic, Continuum of Financial Responsibility, Notice of Privacy Practice Acknowledgement, and Patient Acknowledgement of Financial Policy.