All new NASH patients must fill out the Patient Information, HIPAA and Informed Consent, and Medical Records Release forms. Click each HIPAA-compliant form title below and fill out all the fields. Remember to click “submit” on the bottom of each completed form to send it to our team for review.

Patient forms are available in English and Spanish. 

• Patient Information
• HIPAA and Informed Consent
• Medical Records Release

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