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


New Patient Forms (ALL)

Updated 11/9/2023

Patient Privacy Forms


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


No data was found


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


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


Ring Central Phone Cheat Sheet

Updated 2/3/21

Secret Santa 2023


Surgery Center Covid Questions

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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