New Patient Intake Forms
New Patient Appointments:
What you need with you for your 1st appointment before treatment is administered:
Complete New Patient Intake Forms –
Please complete each form prior to your appointment time.
PRINT: Fill out and bring in your form.
COMPUTER: (download Adobe Acrobat Reader DC, free). Save, fill out & email/share with us.
PHONE/TABLET: (install the Adobe Fill & Sign app, free.) Save, or we can email it to you, fill out & email/share back to us.
Our email address is email@example.com.
Non-parent or guardian –
Bringing a minor child requires a signed authorization note from parent or guardian allowing you to bring the child to our clinic.
You must give a 24 hour notice to cancel your appointment.
If a 24 hour notice is not given you will be charged the rate of service which is $150.00.
For office hours, contact & location information, visit our Contact page.