Forms can be completed online through the patient portal or you can print them from our website and bring them with you to your appointment.
"My husband and I have been seeing Dr Cyr for roughly 20 years (he’s young, we’re old!). He was recommended to me by my father who said he was professional and friendly. We found him to be so and much more! Dr Cyr takes time with each patient and ensures that all needs are met while maintaining an upbeat, friendly delivery. He’s funny when he can be, serious when he needs to be. We think that’s the best kind of doctor! His office staff is always pleasant, kind and helpful. A visit to this office is sure to be a good experience!"
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. Autorización De HIPAA Para Divulgar Información Del Paciente
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
Virtual Visit Policy (PDF) - This policy describes the process for the documentation, maintenance, and transmission of information using virtual visit technology.
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. Política Financiera (PDF)
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. Aviso de prácticas de privacidad (PDF)