Following are the New Patient Forms all new patients coming into the office must fill out (over the age of 18).
Save time by filling them out beforehand! Feel free to fax the completed forms to our office or just bring them in with you on your first visit. Welcome to the office!
New Patient Intake Form page 1
New Patient Intake Form page 2
Example of codes you might see on your explanation of benefits (EOB) if using insurance**
**Note: Not necessarily the charges we bill you
Authorization to bill your insurance (need only fill out if you have insurance)