The following forms are available for review / completion before the initial visit:

New Patient Packet

New Patient Packet
Complete packet to be completed by all new patients.


Individual Forms

Patient Information & Office Policies
All new patients must complete and sign this form. Please complete the sections with your demographic, emergency contact, and insurance information, and read and sign the sections regarding privacy and office policies.

Medical History
All new patients must complete this form. This provides us information about your referring doctor, medical history, current medications, allergies, and current symptoms. Please attach additional pages if more room is required.

Notice of Privacy Practices
The Privacy Rule was a 2000 addendum to HIPAA. The goal of our privacy practices is to assure that individuals’ health information is properly protected while allowing the flow of health information to provide and promote high quality health care. Our Notice of Privacy Practices describes how health information about you (as a patient of this practice) may be used and disclosed, and how you can get access to your identifiable health information.Patients have a right to amend the Privacy Practices as they see fit. However, Howard Sofen, MD, is not obligated to see a patient on the amended terms.

Consent to Treat an Unaccompanied Minor
If a 16- or 17-year-old will be returning for several follow-up visits for the same condition, this form may be used to allow that patient to be seen without their parent/guardian present. This only applies to returning patients. Please specify the condition or conditions the patient may be seen for. This must be signed by a parent or legal guardian.