All new NASH patients must fill out the Patient Information, HIPAA and Informed Consent, and Medical Records Release forms. Click each patient form below, fill out the forms, and then hit “submit” on the bottom of each completed form.

Spanish patient forms

• Información del Paciente
• Consentimiento Informadopara Farmacia Especializada
• Formulario de Divulgación del Historial Médico del Paciente

LET’S TALK