Before your first appointment, please fill out the paperwork below. Provide as much detail as possible to ensure we have a
complete picture of your health history and are aware of any concerns that could affect your care. You can return these forms
during your first visit.
To make appropriate health recommendations, we need some information about your past medical history and current use of medications. Please fill out this form with as much detail as possible to ensure we have the information needed to develop a comprehensive treatment plan.
It's important that we have your current contact information and insurance details on file. Please provide your name, address, telephone number, and billing information on this form.
The Patient Authorization Record indicates that we have your permission to treat you and bill you for the services we provide. It also contains details about billing and assignment of benefits.