Patient Enrollment

Our associates are highly qualified and experienced, and are passionate about the care they provide. Not only will our providers treat your existing conditions, we will also help to create a custom recovery plan that’s right for you. We strive to help you improve your quality of life.

Please begin with the  Patient Enrollment  and complete all Forms. Click submit when finished.

Patient Intake Form 

Text Consent

HIPAA Authorization

Enrollment

Text Consent

HIPAA Authorization

Anxiety Questionnaire

Medical History

Health Questionnaire

Authorization to Release Healthcare Information

Medical History

Health Questionnaire

Mood Questionnaire

Authorization to Release Health
Information

Mood Questionnaire

Anxiety Questionnaire

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