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Patient Forms

In an effort to save you time in our office, you can download and complete our patient form(s) prior to your appointment.

Adult Patient Forms

Adult Patient Forms

15 & Under Patient Forms

15 and Under Forms

 

Welcome Form New Patient
15 & Under Form: Welcome Form New Patient
15 & Under Form: Entrance Symptom Checklist
Optomap Agreement Form
Consent to Disclose Medical and Payment Information
Notice of Privacy Practice (HIPAA)
15 & Under Form: Notice of Privacy Practice (HIPAA)
15 & Under Welcome Forms for Soonercare Patients
Optomap Agreement Spanish Form
Consentimiento para divulgar informacion medica y de pago
Today's Visit

Learning Resources for Patients

Anderson Chiropractic & Wellness
(chiropractic and wellness care)

Care Pharmacy
(local pharmacy services)

Northfield Chiropractic
(expert chiropractic services)

Dr. Bill's Clinic
(personalized healthcare)

CTH Healthcare
(community healthcare services)

Duchesne Clinic
(health services for underserved populations)

Chronic Pain Relief Treatment
(medication, physical therapy, telemedicine, lifestyle adjustments, and supportive care)

Green Valley Chiropractic
(chiropractic services)

The Center for Health and Wellbeing
(comprehensive medical services, integrative care, holistic treatments, and personalized wellness solutions for families)

AmeriDental Group
(affordable dental care)

Fountain Grove Dental
(family dental care)

Mental Health America of Southeastern Arizona
(mental health resources)

All Valley Home Care
(home healthcare services)

Surgery Information Center
(surgical procedures and information)

Doctor Steve's Clinic
(holistic medical care)

Precision Dental
(general dentistry services)

Oro Surgery
(oral and maxillofacial surgery)

Advanced Family Care
(comprehensive care services, vision exams, and eyewear solutions for all ages)

ABH Pharma
(custom supplement manufacturing, private label solutions, and nutraceutical development)

White Mountain Dental
(dental services in Rock Springs, Wyoming)

Montgomery County Health Department
(public health and prevention programs)

Tampa Chiropractic & Wellness Center
(holistic chiropractic care)

Advance Dental Care
(comprehensive dental care, emergency dentistry)

EPA Dental
(dental care and services)

El Camino Surgery Center
(surgical care and outpatient services)

Umbrella Clinic
(comprehensive health services)

Capella Healthcare
(comprehensive healthcare management)

Community Health System
(regional health system)

Genesis Dental Care
(dental services for all ages)

Carolina Sports Medicine
(sports injury and orthopedic care)

Washington Healthcare Alliance
(healthcare advocacy and resources)

Walsh Wellness Center
(holistic health services)

Healthy Kids Dane County
(community health programs for children)

Online Pharmacy NZ
(trusted online pharmacy offering a wide range of prescription medications, health products, and over-the-counter remedies delivered across New Zealand)

Anberry Hospital
(acute and long-term healthcare)

Florida Wellness Institute
(holistic health services, chiropractic care, and integrative medicine therapies)

P2RX
(public health information resources)

George Dermatology
(comprehensive dermatology care, acne treatment, and cosmetic skin solutions)

Northside Family Dental Care
(family dental care)

New York Downtown Hospital
(comprehensive healthcare services)

ANB Wellness Center
(alternative health and wellness)

Palm Desert Implant Dentist
(dental implants and restorative dentistry)

Cancer Research UK Centre Glasgow
(cancer research and support)

Columbia SC Dentist
(comprehensive dental care)

Collingham Dental Clinic
(family dental services)

Melanoma Care
(melanoma treatment and research)

Dr. Kat's Clinic
(personalized medical care)

Healthy Lungs
(comprehensive pulmonary care, asthma and COPD management, and respiratory diagnostics)

Hillbrook Dental
(comprehensive dental services)

Daniel Craviotto MD
(orthopedic surgery, sports medicine, and joint replacement solutions)

True Skin Care Center
(medical acne treatment, isotretinoin therapy, and personalized dermatologic solutions)

Columbia Urological Associates
(advanced urologic care, erectile dysfunction (ED) treatment, minimally invasive surgery, and urinary disorder management)

Center for Endocrine Care
(thyroid and hormone disorder treatment, diabetes management, and endocrine diagnostics)

Saint Vincent Clinic
(healthcare for the uninsured)

Davis Oral Surgery Center
(oral surgery and dental implants)

Ash Chiropractic & Wellness
(chiropractic and wellness care)

Weston Dental Care
(comprehensive dental services)

Mental Health America of Central Carolinas
(mental health support and resources)

ProLife Healthcare
(family-oriented healthcare services)

Westford Internal Medicine
(primary care services, telemedicine consultations, and chronic condition management)

DrX Medical Clinic
(medical services and care)

Millbrae Hospital
(professional healthcare services)

Breathe America
(advanced respiratory care, allergy treatments, and pulmonary solutions for all ages)

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