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The form below is for BASIC INFO & INSURANCE, which comes to us electronically.
PLEASE NOTE, when you come for your appointment,
you will also be asked to fill out a MEDICAL HISTORY and a HIPAA form.
Patients who prefer to print all paper documents (which include Medical History and HIPAA),
click NEW PATIENT FORM ,
fill out, and bring to your visit. Thank you.
Please be sure to click Submit Form.
We will receive it electronically and help make your visit as smooth as possible.
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