Pontchartrain Cancer Center
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  • CLINICAL TRIALS
  • CHEMOTHERAPY GENETIC COUNSELING & TESTING YOUR THERAPY
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  • YOUR VISIT PATIENT PORTAL NEW PATIENT FORMS
  • WHAT IS CANCER? CANCER NUTRITION CHEMOTHERAPY SIDE EFFECTS OF CANCER TREATMENT RADIATION THERAPY SURGERY TREATMENT OVERVIEW PCC ADVOCATES SPARK
  • CONTACT
Pontchartrain Cancer Center
  • Home/
  • About /
    • ABOUT
    • OUR TEAM
  • CLINICAL TRIALS/
  • SERVICES/
    • CHEMOTHERAPY
    • GENETIC COUNSELING & TESTING
    • YOUR THERAPY
  • CANCER LIBRARY/
  • PATIENT INFO/
    • YOUR VISIT
    • PATIENT PORTAL
    • NEW PATIENT FORMS
  • RESOURCES/
    • WHAT IS CANCER?
    • CANCER NUTRITION
    • CHEMOTHERAPY
    • SIDE EFFECTS OF CANCER TREATMENT
    • RADIATION THERAPY
    • SURGERY
    • TREATMENT OVERVIEW
    • PCC ADVOCATES
    • SPARK
  • CONTACT/
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Pontchartrain Cancer Center

NEW PATIENT FORMS

Pontchartrain Cancer Center
  • Home/
  • About /
    • ABOUT
    • OUR TEAM
  • CLINICAL TRIALS/
  • SERVICES/
    • CHEMOTHERAPY
    • GENETIC COUNSELING & TESTING
    • YOUR THERAPY
  • CANCER LIBRARY/
  • PATIENT INFO/
    • YOUR VISIT
    • PATIENT PORTAL
    • NEW PATIENT FORMS
  • RESOURCES/
    • WHAT IS CANCER?
    • CANCER NUTRITION
    • CHEMOTHERAPY
    • SIDE EFFECTS OF CANCER TREATMENT
    • RADIATION THERAPY
    • SURGERY
    • TREATMENT OVERVIEW
    • PCC ADVOCATES
    • SPARK
  • CONTACT/
 

NEW PATIENT FORMS AND INFORMATION

Please click the name of the form below to view, download or print.

  1. Authorization for Use and Disclosure of Health Information

  2. Authorization for Use and Disclosure of Protected Health Information

  3. Notice of Privacy Practices

  4. Acknowledgment of Receipt of Notice of Privacy Practices

  5. Patient Intake Sheet

  6. Patient Rights and Responsibilities

  7. Policies and Procedures

  8. Cancer History Questionnaire

 
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 NON-DISCRIMINATION NOTICE

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