Please download and fill out new patient packet and bring with you to your first appointment.
Click here to download PDF or Click here to download word
If you are a telehealth only patient, you can download and fill out the forms and either email or mail the forms to the office.
Any information you feel uncomfortable sending (credit card, insurance information) you can leave blank and I will fill in
during our first video session. Please sign and date all five signature areas.
* Disclaimer: Please be advised that there are risks to the confidentiality of information sent via email. If you are prepared to accept the risks, emails containing patient information can be sent without violating HIPAA Rules.