Below you will find links to a variety of forms that you may print out and complete prior to an appointment or refer to as necessary during the course of your treatment. The forms below can be viewed, filled out, saved and printed using Adobe Reader (PDF).

If you are a new patient and would like to save time during your initial visit, please fill out the first two forms (Patient Demographics and Medical History) and bring them with you at your first appointment.

New Patient Demographics - Download (PDF)

New Patient Medical History Form - Download (PDF)

New Patient Medical Release to TCI - Download (PDF)

Patient Release of Information from TCI – Download (PDF)

New Patient Consent Form - Download (PDF)

Chemotherapy Consent - Download (PDF)

Notice of Privacy Practices – Download (PDF)

Receipt of Notice of Privacy Practices - Download (PDF)

Bone Marrow Biopsy Instructions – Download (PDF)

 

New patients may only set an appointment for the following hours:

Monday: 2:00 p.m. - 4:00 p.m.
Tuesday - Thursday: 1:30 p.m. - 4:00 p.m.