Patient Registration

You can now register online: Click here

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If you prefer, instead of using our online system above, you can download our forms below, fill them out and bring them to your visit:

Demographic and History Packet (Adults - for patients 18 years old and older)

Demographic and History Packet (Pediatrics - for patients 17 years old and younger)

​Please note that DOT physical exam clients and Auto Injury clients that elect to not register online should not fill out the above paperwork but instead arrive at their appointment 15 minutes early to complete the required paperwork.

Other Policies and Forms 

Medical Records Release Form  -  Patients who are seen in our office can obtain a copy of their records from one of their previously seen doctors or clinics.  To start this process, fill out this form and return it to our office (via fax, mail, or drop it off at our office).

Patient Financial Policy

​Notice of Privacy Practices (HIPAA)