Forms
Before your first visit to my office, please print the New Patient Information and Consent Form, fill it out and bring it with you to your appointment.
If you are in treatment with another provider, or if there is a doctor or therapist with whom you would like me to communicate, please print the Release of Information Form, fill it out with the name and contact information of the other provider, and bring it to your appointment.
If you have insurance through Mines & Associates, please print the Health Insurance Claim Form, fill out the top half of the form, and bring it with you to your appointment.
New Patient Info and Consent