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Please Note
The following forms must be printed and brought with you to the office. DO NOT E-MAIL. Due to HIPAA rules we cannot accept these via e-mail
- Welcome
- Demographic Sheet
- Review Of Symptoms Form
- Patient History Form
- Family History Form
- HIPAA Privacy Form
- HIPAA Acknowledgement Receipt
- Authorization Disclosure Form
- Medical Provider Release of Information Form
- Payment And Fee Agreement
- Patient Portal Access Form
- Functional Medicine Acknowledgment Form