New Patients

In order to process your paperwork in a timely manner, please printout and complete the following forms. These completed forms should be handed in upon arrival on your first visit to our office. Thank you for your cooperation and if you have any questions, please contact our office.

 

 

 

Office Hours
 
Monday 7:00am - 11:00am & 3:00pm - 6:30pm
Tuesday 9:00am - 12:00pm & 3:00pm - 5:00pm
Wednesday 7:00am - 12:00pm & 3:00pm - 6:30pm
Friday 7:00am - 12:00pm & 3:00pm - 6:30pm
Saturday 8:00am - 10:30am (We are open most Saturdays)

To open the following forms, you will need Adobe Acrobat which you can download here.
 

Acrabat

New Patient Forms
Click Link Below to Open Form
  1 - How This Office Is Different From Others Office is Different PDF
  2 - We're Glad You're Here Glad Your Here PDF
  3 - Financial Policies Financial Policies PDF
  4 - Application for Treatment Application for Treatment PDF
  5 - Family Health History Family History PDF

  6 - Patient Consent for Use & Disclosure
       of Protected Health Information

Patient Consent PDF
  7 - Office Policy - Insurance Assignment Office Policy PDF
  8 - Insurance Information Insurance Info PDF
  9 - Payment Authorization Payment Authorization PDF
10 - Review of Systems Review of Systems PDF