New Patient Registration

We are accepting new patients!

 

Please complete the New Patient Check-In Sheet below.  Can be completed on computer or phone.  Once we receive your information, we will call you to schedule an appointment.

 

We do not take any insurance or government payments; we are a direct-pay clinic.  However, we can see anyone, regardless of whether they have insurance or not.

 

If you have questions or need to send us additional information, see our contact information.

 

Don't want to use the form below?  Go here to use the downloadable forms.

 

 

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New Patient Check-In/Registration Sheet (complete separate form for each patient)

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