Forms

In an effort to make you more comfortable when you arrive at our office and to streamline the patient check-in process, you will be able to complete all the necessary items prior to your visit.  Please support us in this endeavor and complete as much paperwork online as possible.

After you have scheduled an appointment, please click on the "Patient Health History Form" link and follow the directions for a new patient.

If you are a returning patient, we will provide you with a passcode to update your existing information.

Please remember to fill out both tabs: DEMOGRAPHICS and MEDICAL HISTORY, before you click "submit".

If you need records sent to us, please print the "Records Release", fill it out and fax it to your previous or referring doctor.

All patients must consent to our privacy practices. You will be asked to sign a consent form when you arrive for your child's appointment. In order to review our privacy practices, please click on the "Statement of Privacy Practices - HIPAA" link. There is no need to print this.


ONLINE FORMS:

Patient Health History Form 

COVID/ Wellness Form


PRINTABLE FORMS:

privacy-policy.pdf

records-release.pdf

SECURE PATIENT PORTAL:

Patient Portal


Contact Us

We look forward to hearing from you.

Location

Hours of Operation

Monday:

8:00 am-6:00 pm

Closed 12-1 pm for Lunch

Tuesday:

8:00 am-6:00 pm

Closed 12-1 pm for Lunch

Wednesday:

8:00 am-6:00 pm

Closed 12-1 pm for Lunch

Thursday:

8:00 am-6:00 pm

Closed 12-1 pm for Lunch

Friday:

Closed

Saturday:

Closed

Sunday:

Closed