Patient Forms
Download and complete these forms before your visit to save time and ensure a smooth check-in process.
Available Forms
We offer our patient forms in both English and Spanish to ensure accessibility for all members of our community. Please download and complete the appropriate form before your appointment.
How to Use These Forms
Download the Form
Click the download button for your preferred language (English or Spanish).
Complete at Home
Fill out the form completely with accurate information. Take your time to ensure all details are correct.
Bring to Appointment
Bring the completed form with you to your appointment to expedite the check-in process.
Save Time
Completing forms in advance can reduce your wait time by up to 15 minutes during check-in.
Need Help?
If you have any questions about completing these forms or need assistance, please don't hesitate to contact us.
All Forms
2025 Patient Financial Application Form
Complete the patient financial application form for new and returning patients.
DownloadFormulario de solicitud financiera del paciente 2025
Complete el formulario de solicitud financiera del paciente para pacientes nuevos y existentes.
DescargarNew Patient Intake Form
Complete this intake form for new patients to provide your medical history and personal information.
DownloadTCC General Consent for Care + Treatment
General consent form for care and treatment at TCC Health facilities.
DownloadAuthorization for Release of Information
Authorize the release of your medical information to designated individuals or organizations.
DownloadHIPAA Acknowledgement of Privacy Practices
Acknowledge that you have received and reviewed our HIPAA privacy practices.
DownloadHIPAA Joint Privacy Notice
Review our joint privacy notice explaining how we protect your health information.
DownloadNYS Patient Bill of Rights for Diagnostic and Treatment Centers
Review your rights as a patient in New York State diagnostic and treatment centers.
DownloadInsurance Enrollment Assistance
Information about our insurance enrollment assistance services.
DownloadLanguage Assistance Rights
Information about your rights to language assistance services during your visit.
DownloadFormulario de Consentimiento para Menores
Formulario de consentimiento para el tratamiento de pacientes menores de edad.
DescargarReady to Schedule Your Appointment?
Download and complete your forms, then schedule your appointment with one of our healthcare providers.