Patient Forms

COVID-19 Supplemental Health Questionnaire and Informed Consent Form

All patients should complete and submit the Supplemental Health Questionnaire before every appointment. Additionally, we request all patients complete and submit the Informed Consent Form prior to the first appointment following our office re-opening. This form only needs to be completed once.

Please contact our office if you have any questions about these forms.

• COVID-19 Health Screening Questionnaire
• COVID-19 Informed Consent Form

New Patient Forms

Please provide us with a health history form for the patient beginning treatment. This can be done by clicking on the Online Health History form to submit the information online or clicking on the Printable Health History form, filling in the information and bringing the form to the appointment.

Also, please review the Notice of Privacy Practices. You can download and print out the Acknowledgement form as well as the Privacy Authorization or sign them when you come into the office. We look forward to meeting you soon!

• Online Health History Form
• Printable Health History Form
• Notice of Privacy Practices
• Acknowledgment of Receipt of Notice of Privacy Practices
• Privacy Authorization