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John Tierney, MD, PLLC
Home
About
Services
Patient Forms
Contact Us
John Tierney, MD, PLLC
Home
About
Services
Patient Forms
Contact Us
Home
About
Services
Patient Forms
Contact Us

Please Print and Complete the following forms before your first appointment:

  • New Patient Packet 

  • Notice of Privacy Practices

  • Acknowledgement of Privacy Practices

  • Release of Information Consent

  • Medicare Opt-Out Contract (Medicare Patients Only)

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