While we are temporarily closing to new patients, you are welcome to complete the new patient paperwork and schedule an appointment when the practice re-opens to new patients in September of 2017. Our goal is to assure you are scheduled for the appropriate amount of time with the provider who is best able to assess and address your needs. Therefore, we ask that you please drop off, fax or e-mail the following forms to the office, prior to calling to schedule an appointment.
- Patient Information and Consent Form
- Medical history form
- Medical Records Request TO FFM– especially If you have a complicated medical history
- Copy of insurance card (both sides, please)
Additional Information and Forms
- Notice of privacy practices
- Minor Consent Form
- Office Financial Policy
- Medical Records Request FROM FFM
- Pay your bill online for patients enrolled in our patient portal
Select the form that you find of interest and it will download to your computer or open up within Adobe Acrobat Reader® within your web browser.
If you do not have the Adobe Acrobat Reader® click here to have it installed onto your computer.