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