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. This will help us understand your health history, gather insurance information, and ensure that we honor your communication preferences and that you are aware of our privacy practices.

2018 HIPAA & Patient Registration (English)

2018 HIPAA & Patient Registration (Spanish)

Health Questionnaire

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