Call: 860-258-3470

Patient Forms


Below are patient forms required for appointments in all departments, with the exception of Sleep and Pulmonary. Those departments will have specific forms provided at registration.

Please print and complete the forms below prior to your visit. This will help us understand your health history, gather insurance information, and ensure that we honor your communication preferences and that you are aware of our privacy practices.

2023 HIPAA & Patient Registration (English)

2023 HIPAA & Patient Registration (Spanish)

Health Questionnaire

If you would like to authorize Starling Physicians to obtain or release your medical records, please complete the following form.


Medical Records

Accessing Medical Records: Under federal and state law, patients have a right to access their medical records. The Health Information Management department will generally honor a patient’s request to furnish information to another party which may include but not limited to another physician, hospital, medical facility, attorney, government official, or insurance company.

If you would like to submit an online request to obtain patient health information from Starling Physicians, please click the link below:

Request Medical Records

For further assistance, please contact the Health Information Management (HIM) department at 888-569-0629.

Business hours of operation are Monday to Friday from 8am-8pm EST (excluding holidays).