TRC Health Downloadable Forms

Patient Registration

You can help expedite your initial consultation with TRC by downloading and completing our Patient Registration Form prior to your first visit.

Privacy Practice Reception

We must have all patients sign the Reception Form to prove that we have made our privacy policies available for your review.

Financial Agreement

This form outlines how you intend to pay for your TRC treatment, including your insurance billing information.

HIPAA Notice of Privacy Practices

We are required by law to keep medical information about you private, to give you this notice of our legal duties and privacy practices with respect to your medical information, and to follow the terms of the notice that is currently in effect.

Agreement Not to Use Other

Testosterone Supplementation

This form is your promise to not combine other testosterone supplementation with your TRC treatment plan.

TRC  © 2016 · ALL RIGHTS RESERVED

Our Three Locations

TRC OF PROVIDENCE, RI

TRC OF WARWICK, RI

TRC at AGAPE FALL RIVER, MA

49 Seekonk St. #3 Providence, RI 02906

400 Bald Hill Rd #506, Warwick, RI 02886

775 Davol St. Rivervue Professional

Bldg. 3rd Floor. Fall River, MA. 02720