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.
Steps for New Patients:
1. Complete New Patient Intake Forms Options
a) PRINT: Fill out and return.
b) COMPUTER: (download Adobe Acrobat Reader DC, free).
c) PHONE/TABLET: (install the Adobe Fill & Sign app, free.) Save, or we can email it to you, fill out & email/share back to us.
2. Turn in your Paperwork
Return to us via email to email@example.com, mail, or drop by the clinic.
3. We will call you to schedule
Look forward to meeting you.
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.
Forms of Payment
We do not work with your health insurance companies.
You are more than welcome to request a receipt called a SUPERBILL with proper coding to send in on your own to apply charges for our services toward any possible deductibles you may have in your health care plan.
We accept cash, checks, HSA/FSA, as well as most debit and credit cards.
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.
For office hours, contact & location information, visit our Contact page.