contact DECO

GET IN TOUCH WITH US

Are you a current patient? If so, please call the office directly or use the Patient Portal to communicate with our office. All other inquiries are welcome in this forum.

Thank you! Your submission has been received!

Oops! Something went wrong while submitting the form

PRACTICE INFORMATION

patient forms, policies & additional resources

Patient Forms

  • Notice of Privacy Practices (PDF) - Describes how health information about you (as a patient of this Care Center) may be used and disclosed, and how you can get access to your individually identifiable health information. Please review this notice carefully.
  • Authorization for Release of Medical Information (PDF) - Allows patients to authorize the disclosure of their health information to a designated individual, company, agency, or facility.
  • Authorization and Consent for Treatment (PDF) - All patients must provide their consent for treatment, communications (calls, emails, and text messaging), and agreement of financial responsibility. Autorización y Consentimiento Para el Tratamiento
  • Preferred Contacts (PDF) - Patients are encouraged to complete and return the Preferred Contacts Form but it is not required. Contactos Preferidos
  • Financial Policy (PDF) - This form advises patients of their complete financial responsibility for all medical services received without regard to insurance eligibility or coverage determinations.
  • Language Services

policies

Prescription Refill Request Policy
All refills should be called directly in to the pharmacy when you are within a week of running out of medication. Routine refill requests should NOT be called in to the office. If there is a change or special circumstance, contact the office via email or phone. Routine refill requests will not be processed after business hours or on week-ends and holidays. It is your responsibility to monitor your medications and track when you are running low.

Late Policy
If you are more than 10 minutes late for your scheduled appointment, you may be asked to reschedule your appointment.

Physician Forms

Consultation Request 
DECO Consultation Request (PDF)