Solace New Patient Request Form
Thank you for choosing our office. In order to serve you properly we will need the following information. All information will be held confidentially.
Authorization for Use or Disclosure
By downloading, completing and returning this form to Solace Cancer Care, you give us permission to share your health information with other health care providers who need it to help us in your treatment.
Individual Health Information Consent Form
This document will give Solace Cancer Care your permission to use and disclose your health information for treatment, payment, and/or health care operations.
All patients must read and sign the Financial Policy form.