New Patient Forms
Welcome!
PATIENT REGISTRATION FORMS
The following forms are used to register new patients, and filling them out ahead of time will speed up your first visit. If you are able to, please print and bring them with you to your first appointment. Click on the links below for each form you can print and fill out:
Patient Receipt for Notice of Privacy Protection
Language Assistance & Non-Discrimination Policy
PRIVACY POLICY
Our Privacy Policy (which explains how we keep your medical information private) can be found and printed below. It can also be viewed on this website (click PRIVACY POLICY). We can also provide a copy of it to you at your request.
Click on the link below to print a copy:
Dr. Richard P. Walsh
960 W Wooster St, Ste105
Bowling Green, OH 43402
PHONE: (419) 353-6262
OFFICE HOURS:
Monday
8:30 am - 7:00 pm
Tuesday & Thursday
8:30 am - 5:00 pm
Wednesday
8:30 am - noon
Friday
8:00 am - 2:00 pm