Please complete the necessary forms as needed.  You can fill them out online for in-office or telemedicine visits or download them here to print and complete by hand.

The information you submit in our HIPAA-secure forms is protected health information and will be used only by this office unless you provide a written release.
**Please do not use use your auto-fill function, it creates a problem for some users that prevents advancing and completing the form**

Complete this intake form if you are scheduled for a consultation for COVID-19 prevention or treatment

New Patient Intake

Express Visit Intake

In-Depth Follow-up Visit Intake

Education Visit Intake (for out-of state)

Medical Records Release Form

                  Please contact the office

Privacy Policy


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