Call: 860-258-3470

Patient Forms


Below are patient forms required for appointments in all departments, with the exception of Sleep and Pulmonary. Those departments will have specific forms provided at registration.

Please print and complete the forms below prior to your visit.

Health Questionnaire

Patient Registration

In addition, we kindly ask you to fill out a HIPAA calling information form so we can honor your preference for communications. Please fill out both sides indicating that you are aware of our privacy practices.

HIPAA Form

If you would like to authorize Starling Physicians to obtain or release your medical records, please complete the following form.

Authorization to Obtain/Release Medical Records