Patient Forms for Your First Visit
During your first appointment at Comprehensive Cancer Centers of Nevada, you will be asked to complete a number of patient forms.
Medical Oncology
- Fadi Braiteh, MD
- Stephani Christensen, MD
- Khoi Dao, MD
- Muhammad Ghani, MD
- Oscar B. Goodman Jr., MD, PhD
- Vikas Gupta, MD
- Regan Holdridge, MD
- Henry Igid, MD
- Karen S. Jacks, MD
- Clark S. Jean, MD
- G. H. Kashef, MD
- Dhan Kaushal, MD
- Edwin Kingsley, MD
- Anthony V. Nguyen, MD
- Gregory Obara, MD
- Rupesh J. Parikh, MD
- H. Keshava Prasad, MD, FRCP, FRCPath
- Ramalingam Ratnasabapathy, MD
- Wolfram Samlowski, MD, FACP
- Hamidreza Sanatinia, MD
- James Sanchez, MD
- Adit Shetty, MD
- Anu R. Thummala, MD
- Restituto Tibayan, MD
- Brian Vicuna, MD
- Nicholas J. Vogelzang, MD, FASCO, FACP
Radiation Oncology
- Michael J. Anderson, MD
- Andrew M. Cohen, MD
- Dan L. Curtis, MD
- Samual R. Francis, MD, MS
- Farzaneh Farzin, MD
- Raul Meoz, MD, FACR
- Matthew W. Schwartz, MD
- Michael T. Sinopoli, MD
Breast Surgery
- Souzan El-Eid, MD, FACS
- M. Ferra Lin-Duffy, DO
- Rachel Shirley, DO
- Josette E. Spotts, MD, FACS
- Margaret A. Terhar, MD, FACS
Lung Center of Nevada
- Sapna Bhatia, MD
- Nisarg Changawala, MD, MPH
- John (Jack) Collier, MD, FCCP, DABSM
- James S. J. Hsu, MD, FCCP, DABSM
- Ralph Nietrzeba, MD, FCCP, FACP
- George S. Tu, MD, FCCP, DABSM
- John Wojcik, MD, FCCP, DABSM
Generic
- Electronic Prescription Form (pdf)
- Notice of Privacy Practices – English (pdf)
- Notice of Privacy Practices – Spanish (pdf)
- Acknowledgement of Receipt of Notice of Privacy Practices (pdf)
- Using and Disclosing Protected Health Information for Involvement in the Individual’s Care and Notification Purposes (pdf)
- My Care Plus Consent – English (pdf)
- My Care Plus Consent – Spanish (pdf)