Patient Care

Patient Forms

Summit Endocrinology Forms

First-time patients are asked to print out and complete all forms in the New Patient Packet prior to your visit. If you are not able to complete the forms ahead of time, we ask you to arrive approximately 30 minutes before your appointment to complete the forms in the office. Please be sure to read the Notice of Privacy Practices prior to completing the packet.

The packet includes the following forms:

  • Patient Information
  • Health History
  • Financial Policy and Patient Responsibility
  • Privacy Practice and Designation of Disclosure

After your visit, we would appreciate if you would complete our Patient Survey. We strive to provide only the highest quality of care, and your feedback will provide us with valuable information.