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New Patient Forms

We welcome new patients with Medicare or Medicare Advantage Plans. To get started, please schedule a time to speak with our New Patient Coordinator by clicking below, or call 530-395-2610. During this call, we will confirm your coverage and send you our new patient packet.

Established Patient Forms

The forms below are for current Juniper patients only. If our staff has asked you to complete a specific form, please select the requested form from the list below.  If you are a new patient, please see the top of this page.

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    Please provide your essential contact details, personal information, and emergency contacts so we can accurately establish your profile.

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    Detail your past illnesses, surgeries, current medications, and family health background to help our clinical team understand your comprehensive health picture.

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    Review and acknowledge our privacy practices detailing how your sensitive personal health information is legally protected, utilized, and securely shared.

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    Authorize our billing department to formally submit claims and process payments directly with Medicare for your covered medical services.

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    Grant permission for your provider to utilize secure, ambient AI transcription technology during your appointment to assist with accurate clinical charting.

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    Agree to participate in coordinated care programs designed to provide you with continuous health monitoring and dedicated support between your standard office visits.

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    Authorize our clinic staff to securely request, receive, or share your medical records with designated family members, specialists, or other external healthcare organizations.

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