Before you can schedule your first appointment, the following forms packet must be completed, submitted and accepted by our office. Please complete ALL 13 pages of the forms by clicking the link provided below. You will be able to submit all the New Patient forms listed below as one PDF document. In order to process your paperwork in a timely manner, please be sure to complete each section in its entirety.
We strongly encourage these forms to be filled out using a desktop computer, laptop computer, or a tablet for ease of use, as the forms may not be mobile friendly.
The New Patient Packet includes:
– Patient Information
– Medical History
– Medication List
– Practice Policies
– Telemedicine Patient Agreement
– Credit Card Information
– Notice of Privacy Policies Acknowledgement of Receipt
Note: Completing the forms online will route you to a secure Adobe fillable form. Once you have reviewed and completed all 13 pages, you will click the blue Submit button, enter your email address and click Submit. Once the document has been processed and submitted to us, you will see a You’re all set page that will indicate you have submitted the “New Patient Packet.” Your forms packet will be delivered to us electronically though a secure document portal. You will also receive a copy of the completed forms.
*Failure to complete the paperwork in full, will delay scheduling an appointment.