Please read this form in its entirety, then bring the completed form to your first appointment. Your signature indicates your agreement to and acceptance of these policies. Should you have questions regarding this form, please ask a member of our office staff.
To help us better serve you, please print and bring this completed form to your first appointment.
Medical History Form
Your answers on this form will help your clinician understand your medical concerns and conditions. All information will be kept confidential.
View our payment forms and cost estimates for your convenience.
Credit Card On File Form
Cost Estimate Form