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Patient Form
Intake Forms
All new patients are requested to complete and sign two documents: a "Patient Information form" and a "Patient Informed Consent to Treat" form for treatment during their first visit, when I conduct a new patient assessment.
During your first visit and beyond, if any health changes, changes in your medications or adverse results occur - please let the Doctor know as soon as possible.
This initial process of document review may take 10 or 15 minutes time. New patients are encouraged to review these forms in advance to expedite the intake process during the first-time visit. This allows us to spend more time discussing your health needs and ensures sufficient time for your treatment.
Veterans and Your Families
I accept Triwest Insurance for Veterans and their families.
Reading and signing this consent form is required for treatment. To view, download, print and complete this form, click the link above.
This form covers all the basics, your personal information, info about your insurance provider, payment authorization and my cancellation policy which I keep on file. To view, download, print and complete this form, click the link above.
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