Submit Your Health History Form Online
Be prepared! In an effort to provide the utmost service to our patients, it is required that all registration forms are completed and medical records received before your scheduled appointment.
It is extremely important that all medical records are delivered to our clinic in advance of your visit. You may fill out the Medical Release Form online and we will obtain records for you. An electronic signature must be provided to verify that the information submitted online is accurate. If you already have your medical records, please provide copies to our office in advance of your appointment. All of our online forms are confidential and sent to our office with secure encryption.
This website is compliant with the Health Insurance Portability and Accountability Act (HIPAA). All of your personal health information is confidential, and will not be shared with anyone, aside from those involved in your treatment, without your consent.