Patient Forms


Click below to fill out new patient intake form for our insurance patients:

ROPT New Patient Intake for Insurance Patients:

Click below to fill out new patient intake form for our cash patients:

ROPT New Patient Intake for Cash Patients:


Click below for our notice of privacy.

ROPT Notice of Privacy


If you would like our team to coordinate care with another physician practice please complete the form below to authorize release of your medical records.

HIPAA Authorization Form


Note: To download Adobe Acrobat Reader for free, click here.

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