New Patient Portal

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Patient Intake Form

Please fill-out, sign and forward to me prior to our first appointment. 

Intake Form

HIPAA 

Please fill-out, sign and forward to me prior to our first appointment. ​

HIPAA FORM

Authorization to Exchange Confidential Information

There may be a need for one of your health care professionals to share information with me. If so, you can download this form, and return the completed version to me with the professional's signature.

CONFIDENTIAL EXCHANGE

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