New Patient Intake Forms
New Patient Appointments:
We are accepting new patients, but have limited time due to our current patient load. You may have to wait a few weeks to get established in our clinic. We typically do not have same day new patient appointments available.
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 return to us via email, mail, or drop by the clinic prior to your appointment.
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 firstname.lastname@example.org.
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 new patient 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.