Patient Forms

For your convenience, we have supplied the following patient forms and resources as Adobe Acrobat files. Feel free to print them out and review them at your leisure.

For new patient forms that require your personal or medical information, please fill out those forms PRIOR to your first house call visit.

Primary Care Forms

• Notice of Privacy Practice - English (pdf) | Aviso de Prácticas de Privacidad - Español (pdf)
• General Consent for Treatment - English (pdf) | Consentimiento General Para Tratamiento - Español (pdf)
• New Patient Referral Form (pdf)
• New Patient Welcome Letter (pdf)
• VPA NoShow Policy Letter (pdf) | Politica de Inasistencia de VPA (pdf)
• Brochure - English (pdf) | Folleto - Español (pdf)

Primary Care -Telehealth Visit Resources

• VPA Telehealth - Patient Guide (pdf) 
• VPA Telehealth - Patient Guide (Spanish) (pdf)
• VPA Telehealth  - Quick Tips for Accessing the Appointment (pdf)

In Home Assessment Forms

• VPA Notice of Privacy Practices NPP (English) (pdf)
• VPA Notice of Privacy Practices NPP (Spanish) (pdf)