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To download the complete packet for new patients click the button below.
Packet includes: initial intake forms, pain evaluation, consent for treatment, authorization of disclosure, payment acknowledgment and medical record request.
Please print and fill out the New Patient Packet to the best of your ability and bring it with you to your first appointment.
For assistance, call 862-336-1600 during regular business hours.
If you are filling out forms for a minor, you will need to sign a consent form on their behalf before we can provide any treatment to the child in your care. A signature of the parent or guardian is required.
You can download the form of consent to treat a minor right here.
Additional Forms:
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