When you visit AZZ Medical Associates, you will have to fill out a few forms before receiving care. Here are the four different forms you will need to complete and where to download them:
HIPPA privacy form
According to the Health Insurance Portability and Accountability Act (HIPPA), you have the right to decide
who has access to your private information and how you receive it, too. This form is for all patients and also serves as a basic contact information form.
Patient information form
When you fill out this form, you will be giving AZZ Medical Associates more detailed contact information.
This form also contains fields to include your insurance information as well as who to contact in case of an emergency.
Epworth Sleepiness Scale form
If you come to AZZ Medical Associates to treat a sleep disorder, you will have to fill out the Epworth
Sleepiness Scale form. The Epworth Sleepiness Scale is a short, basic questionnaire to determine if you
become tired or fall asleep during routine activities, such as riding in a car.
Records release and transfer request form
This very short form authorizes the release of your medical records, including the results of sleep studies.
This form is also used to request a transfer of your records from one medical facility to another, which you must approve by completing this form.