Form Downloads

Most Requested

February 2024

Updated: 2/23/24

February Confirm Calendar

Released: 1/10/2024

History & Ocular Exam

Form to use when NextGen is down!

HNA Policies

Updated 1/10/24

Lab Orders Form

Updated: 9/5/23

March 2024

Released: 2/27/24

March Confirm Calendar

02/23/2024

New Patient Forms (ALL)

Updated 11/9/2023

Patient Privacy Forms

Policy

Employee Emails

Updated 2/2/23

Physician Phone Numbers

Updated 1/8/2021

Plaquenil Treatment Policy

Updated 8/25/2020

Privacy Notice

Released: 11/21/23

Scheduling Policy

Released 8/24/21

Wait List Policy

Released 8/24/21

Schedule

No data was found

Forms

COVID Consent

Updated 7/08/2021

Desk Information

Released 5/5/22

Emergency Contact Form

Released 3/30/23

Event Report, Accident, Injury Fall Incident Report HNA

Date: 4/13/23

Excuse for Accompanying Patient

Released 7/2/21

Excuse Work/School Form 153

Released 7/19/21

HIPAA Form

Updated 9/20/23

HNA Phone Extensions

Updated 6/22/23

Imaging Orders Form

Released 7/8/21

Key Form

Revised 8/19/22

No insurance facility/physician fees

Please make check payable to HNA

Released: 4/19/23

Record Release From HNA

Updated 4/17/23

Record Release To HNA

Updated 4/17/23

Request for Time off

Uploaded 4/19/23

Return Pt. After 3 Years

09/21/2023

Ring Central Phone Cheat Sheet

Updated 2/3/21

Secret Santa 2023

11/17/2022

Surgery Center Covid Questions

You must be logged in to view this content.

Vacation Picks 2024

Please fill out and return to Becca by November 15th even if you are not picking any time in advance.

Released 10/16/23

Versum Visual Acuity & Color Testing Form

Released 4/5/22