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New Patient Questionnaire

PLEASE READ CAREFULLY

The PDF package you are about to download was designed to be completed on your computer to preclude the need for printing and manually submitting the forms. These forms were created in and will only work properly within the Adobe Reader application for both PC and Mac. If you attempt to fill out these forms inside your web browser’s PDF reader, or some other PDF application, the automated features that have been included for your convenience will not function as designed.

You may CLICK HERE or on the Adobe icon below to download the latest version of the free Adobe Reader application. Once it is installed on your computer, open the application and THEN open the document from inside the application. If you prefer, the document can always be printed and submitted manually.

There are complete instructions within the document package for completing and submitting the forms. Once you have completed and saved the document, you may click the SUBMIT button at the bottom of the Instructions page to email it to our office. If you prefer, you may print and deliver it by mail, fax or in person.

If you have any difficulty completing the forms or if the SUBMIT button does not work, please double check that you are using the latest Adobe Reader application. This digital packet will only work properly in Adobe Reader. It is a free application. If you don’t wish to use Adobe Reader, please print the document and complete it with a pen. No appointment will be scheduled until we have had an opportunity to review this completed document. Thanks for your cooperation and we hope this new digital packet proves to be convenient for you.

The New Patient Information and Questionnaire Packet

The New Patient Questionnaire PDF

DOWNLOAD – This questionnaire is required from all new patients before your first appointment date. This new digital version can be completed entirely on your computer and submitted online via email, or you may choose to print it and deliver it by mail, fax or hand delivery. Please download the PDF by clicking one of the links above and then follow the instructions to complete the forms in the comfort of your home. Once submitted to our office, we will schedule your evaluation appointment.

To open and complete this PDF document on your computer, you may download a free copy of Adobe Reader here.

Download the free Adobe Reader