New Patient Forms

The forms below will provide important information about your health history to Dr. Kaufman, and should be filled out before your consultation. You are welcome to fill it out at our office on your first visit, or if you prefer, fill them out online and submit before you arrive. If you choose to fill out the form at our office, please arrive at least 30 minutes prior to your appointment. Please call us if you have any questions.

Fillable Online Forms -


Downloadable PDF Forms -

Financial Policy Form

Download FINANCIAL POLICY Form

New Patient Form

Download New Patient Form

Notice of Privacy Practices Acknowledgement

Download Notice of Privacy Practices Acknowledgement Form

Office Visit Acknowledgement Form

Download OFFICE VISIT ACKNOWLEDGEMENT Form

Vein Health History Form

Download Health History Form