For your convenience, we have supplied our general patient forms below. If you wish, click on the links below, print, complete the forms, and bring them with you to your appointment. Printing them, filling them out and bringing them with you will allow us to attend to your medical needs more quickly than completing them upon your arrival.
REGISTRATION FORM: CLICK HERE
PATIENT BILL OF RIGHTS: CLICK HERE
NOTICE OF PRIVACY PRACTICES: CLICK HERE
HIPPAA FORM: CLICK HERE
PATIENT RELEASE FORM: CLICK HERE
PATIENT QUESTIONNAIRE - ENGLISH: CLICK HERE
PATIENT QUESTIONNAIRE - ESPANOL: CLICK HERE
If, for some reason your service was not satisfactory, by any means, please print and fill out the Patient Complaint Form.
CIRCLE CARE Center
618 West Avenue
Norwalk, CT 06850
PATIENT COMPLAINT FORM: CLICK HERE