In order to assist you in your preparation for your appointment at ASAFHC, we have made most of our forms available online. You have two ways of doing this depending on which is more comfortable for you. With either option, you can reduce the amount of time prior to your appointment and ensure greater accuracy in the information you provide.
OPTION 1: Fill out the forms below by clicking each link to open, then print, complete by hand and bring to your appointment.
OPTION 2: These forms are designed so you can type in required information, check boxes, etc. The only thing you cannot do online is sign the forms – that must be done by hand after you’ve printed the forms. Once you’ve filled in all of the appropriate fields, print each form, sign where appropriate and bring to your appointment.
These forms (Updated 3/2021) are provided as a courtesy and in our effort to simplify and streamline your visit.
ASA Arbitration Agreement (46.42 KB)
Our Insurance Process (38.53 KB)
Patient Background (38.88 KB)
Patient Personal Information (38.88 KB)
Signature On File Form (38.88 KB)
Disclosure Form (45.56 KB)
If you are unable to open the above files, you may download the free Adobe Software here.