Forms

WaitingRoom Before your first appointment, we’d like to know some basic information about you. Please print and complete the attached intake form (for the appropriate practitioner) and bring it to your first appointment. If your medical records are to be forwarded from a different practice, please also complete the release form, below. If you prefer, we can mail the form to you in advance of your appointment. Thank you.

Patient Information Form

Notice of Privacy Practices Form

Health Questions Form

Authorization for Treatment Form

Medical Records Release Form

Insurance

Please note that we no longer accept insurance. Feel free to call us with specific questions at any time at 603.927.4526.