Tel: 614-890-4904

E-mail: DrFidelibus@DrFidelibus.com

Address: 4400 North High Street, Suite 413

Columbus, OH 43214

© 2019 by James A. Fidelibus, PhD LICDC

Preparing for your 

First Appointment

If you're new to our office, please read the information below regarding  paperwork that must be filled out prior to your first appointment. Please be sure to contact our friendly team with any questions or concerns you may have.

Read the HIPPA Statement and Acknowledgement form

These forms make you aware of your privacy and how your health information is stored. You do not have to print out the HIPPA Statement, but please sign and date the HIPPA Acknowledgement form and bring it to your first appointment.

Basic information and more

It's important that we know a little bit about you, so please be sure to fill out the Personal Information form. You'll also want to review and sign the Office Procedures form. This makes you aware of policies and procedures, and allows you to allow or withhold any information being discussed with other medical professionals on a consultation basis.

Consulting with other physicians

If you would like us to consult with other physicians who may have been involved with your care in the past, or who are presently assisting you, please complete the Release of Information form as much as you can. Any questions or concerns involving the form can be discussed when we meet for your initial appointment.

Click Below to Download our Forms