Forms

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*DO NOT EMAIL INTAKE FORMS TO US*

Please bring completed forms in with you upon check-in.

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(Click the format you would like to download)

 

New Patient Intake   PDF 

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Pediatric   PDF .DOC

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STarT Tool  PDF​

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Medical Records

 

When chosen form is completed, you may bring it to the Front Desk, 

Fax, Email or mail it to us.  All fields on the form MUST be completed to be valid.

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Medical Records Release (We will send out)

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Medical Records Request (Records being sent to us)

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