In an effort to make your MEA experience as convenient as possible, we've provided you with the following forms which you can print and fill-out prior to your arrival at any of our clinic locations.
Registration Sheet and Consent for Treatment
+ DOWNLOAD REGISTRATION FORM (pdf)
Acknowledgement of Receipt
Acknowledgement of Receipt of Notice of Privacy Practices
+ DOWNLOAD ACKNOWLEDGEMENT FORM (pdf)
WC / MVA Form - All patients must fill out
Worker's Compensation / Motor Vehicle Accident Form
+ DOWNLOAD WC/MVA FORM (pdf)
Notice of Privacy Practices
Copy of our Notice of Privacy Practices
+ DOWNLOAD NOTICE OF PRIVACY PRACTICES (pdf)
NOTE: Forms are provided in the Adobe Acrobat format.
+ Download Adobe Reader.