Patient Forms

Hyperbaric Medicine Ventura | Dr. J. Thomas Millington, Jr M.D.

Doppler vascular ultrasound Ventura | Dermagraft® Treatment | Apligraf® Treatment

lymphedema treatment Ventura | chronic ulcer treatment | chronic wounds treatment

Dr. J. Thomas Millington, Jr M.D. | 2166 N Moorpark Freeway | Thousand Oaks, CA 91360 | Tel: 805.494.1222

Patient Forms

The following forms can be downloaded to your computer and printed at home. By filling out these forms ahead of time, you will save a significant amount of time during your visit. Please be prepared to provide this information to our office along with your current medical insurance information. If you have any questions when filling out these forms, please do the best you can and our staff will assist you with your questions on the day of your visit.

Patient History Form
Bill of Rights
Notice of Privacy Practices Acknowledgement
Confidential Patient Registration Form

Please note: These documents are in Adobe® PDF format. They require Adobe Reader to be viewed. If you do not have Adobe Reader, you can download it for free by clicking here.